Late In-The-Bag Spontaneous Intraocular Lens Dislocation

We compare and evaluate the visual outcome and complication rate of two different techniques of surgical management of in-the-bag intraocular lens (IOL) dislocation or aphakia correction. in accordance with the improvement of surgical techniques, we compared sutureless and double flange  technique for IOL bag complex repositioning in IOL dislocation..

Eye Clinic University Medical Center “Zvezdara” Belgrade, Serbia.

We retrospectively reviewed the records of seven patients who had undergone phacoemulsification, followed by implantation of a posterior chamber IOL in the capsular bag during the years 2016 through 2023 and who showed IOL dislocation during follow-up.  We aimed to evaluate the patient characteristics, expected visual outcomes, surgically induced astigmatism, and complications. For surgical treatments, we focused on the comparison of the 2 main operation methods: IOL repositioning suturelles intrascleral fixation and IOL repositioning double flange fixation

The median age of eight patients was 62 years (range 47–84 years) and they were 3 women and 5 males. The median implantation duration of the dislocated IOLs was 9.7 years (range 6–21 years). Axial length of the diseased eye was measured as 24.46 mm (range 23.12-25.57 mm).

• 8 eyes (8 patients)
• Mean postoperative follow-up: 3+ 2.8 weeks
• Mean postoperative refraction: − 1,33 ± 1,47 diopter sphere
• Postoperative astigmatism: -1.32 median (for -0,75 to 1.92)
• IOL was well centered and stable in all the patients

This analysis method has the advantage of being able to exclude the influence of various IOL materials or designs on IOL dislocation, but it also has the disadvantage of having a relatively small number of cases.

Late in-the-bag spontaneous intraocular lens dislocation  occurs on average almost 10 years after cataract surgery with a cumulative incidence of 0.6% to 3.2%. None of the operation methods seem superior to the others in all aspects and thus the best choice for all patients with late in-the-bag IOL dislocation. With the advancement of surgical techniques, therapeutic approaches are also changing in accordance with the functional effectiveness of surgical methods. However, increased knowledge is required before specific recommendations can be given.