J Korean Ophthalmol Soc.  2014 Feb;55(2):196-201. 10.3341/jkos.2014.55.2.196.

Comparison of Clinical Outcomes after Various Techniques of Intraocular Lens Dislocation Correction

• Sun JH
• Kim JY
• Kim MJ
• Yoon YH
• Tchah HW

• KMID: 2218411
• DOI: http://doi.org/10.3341/jkos.2014.55.2.196

Abstract

PURPOSE
To compare clinical outcomes of various surgical methods of intraocular lens dislocation correction surgery.
METHODS
We retrospectively analyzed the medical records of patients who underwent intraocular lens dislocation correction surgery with and without vitrectomy by two seasoned surgeons, and compared postoperative best corrected visual acuity and spherical equivalent. Clinical outcomes of secondary intraocular lens insertion after primary intraocular lens removal and primary intraocular lens reposition were compared among the cases without vitrectomy.
RESULTS
Dislocated intraocular lens correction without vitrectomy showed better postoperative visual acuity compared to procedures with vitrectomy (0.35 +/- 0.37 vs. 0.54 +/- 0.18; t-test, p = 0.001), but there were no significant differences in spherical equivalent (1.30 +/- 1.10 vs. 1.80 +/- 1.57; p = 0.24) between cases with and without vitrectomy. In comparing primary intraocular lens reposition and secondary intraocular lens insertion among the cases without vitrectomy, the outcomes did not show significant differences in best corrected visual acuity (0.28 +/- 0.40 vs. 0.40 +/- 0.37; p = 0.38) or spherical equivalent (1.66 +/- 1.43 vs. 1.07 +/- 0.79; p = 0.19). In comparing secondary intraocular lens insertion into the capsular bag and fixation to the sclera, iris and iris sulcus, the outcomes did not show significant differences in best corrected visual acuity (p = 0.49) or spherical equivalent (p = 0.33).
CONCLUSIONS
The various intraocular lens correction methods examined did not show clinically significant differences in best corrected visual acuity and spherical equivalent when performed by experienced surgeons, except for better postoperative best corrected visual acuity in cases without vitrectomy compared to cases with vitrectomy.

Keyword

IOL dislocation; Scleral fixation of secondary IOL; Spherical equivalent

MeSH Terms

Dislocations*
Humans
Iris
Lenses, Intraocular*
Medical Records
Retrospective Studies
Sclera
Seasons
Visual Acuity
Vitrectomy

Reference

References

1. Lee HJ, Min SH, Kim TY.Bilateral spontaneous dislocation of in-traocular lenses within the capsular bag in a retinitis pigmentosa patient. Korean J Ophthalmol. 2004; 18:52–7.

2. Seo MS, Kim CR, Nah HJ. . Management of posteriorly dis-located intraocular lens using pars plana vitrectomy. Korean J Ophthalmol. 2000; 14:80–4.

3. Lee SJ, Choi KS, Park SH, Jung GY.A reverse ab externo scleral fixation for posterior chamber intraocular lens dislocation. J Korean Ophthalmol Soc. 2007; 48:1341–5.

4. Ma DJ, Kim MK, Wee WR.Knotless external fixation technique for posterior chamber intraocular lens transscleral fixation: a 5-case analysis. J Korean Ophthalmol Soc. 2012; 53:1609–14.

5. Botelho PJ, Johnson LN, Arnold AC.The effect of aspirin on the visual outcome of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1996; 121:450–1.

6. Davison JA.Capsule contraction syndrome. J Cataract Refract Surg. 1993; 19:582–9.

7. Jehan FS, Mamalis N, Crandall AS.Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Ophthalmology. 2001; 108:1727–31.

8. Brilakis HS, Lustbader JM.Bilateral dislocation of in-the-bag pos-terior chamber intraocular lenses in a patient with intermediate uveitis. J Cataract Refract Surg. 2003; 29:2013–4.

9. Yamazaki S, Nakamura K, Kurosaka D.Intraocular lens sub-luxation in a patient with facial atopic dermatitis. J Cataract Refract Surg. 2001; 27:337–8.

10. Yasuda A, Ohkoshi K, Orihara Y. . Spontaneous luxation of en-capsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation. Am J Ophthalmol. 2000; 130:836–7.

11. Smiddy WE, Flynn HW Jr.Management of dislocated posterior chamber intraocular lenses. Ophthalmology. 1991; 98:889–94.

12. Lee DG, Nam KY, Kim JY.Modified scleral fixation of dislocated posterior chamber intraocular lenses. J Korean Ophthalmol Soc. 2009; 50:1071–5.

13. Stark WJ, Goodman G, Goodman D, Gottsch J.Posterior chamber intraocular lens implantation in the absence of posterior capsular support. Ophthalmic Surg. 1988; 19:240–3.

14. Lewis H, Sanchez G.The use of perfluorocarbon liquids in the re-positioning of posteriorly dislocated intraocular lenses. Ophthalmology. 1993; 100:1055–9.