Long-term results of late “in-the-bag” IOL dislocation surgery

Abstract

BACKGROUND: Intraocular lens (IOL) repositioning and IOL exchange are the main methods of surgical treatment of late “in-the-bag” IOL dislocation.

AIM: To evaluate refraction, induced corneal astigmatism and IOL tilt after surgical treatment of late “in-the-bag” IOL dislocation by transscleral suture fixation and exchange to “iris-claw” IOL with retropupillary fixation.

MATERIALS AND METHODS: 78 of patients with late “in-the-bag” IOL dislocation were included. Transscleral suture IOL fixation was performed in group I (38 eyes), exchange to “iris-claw” IOL was performed in group II (40 eyes). Refractometry, keratotopography and optical coherence tomography of anterior segment were performed before surgery, 1 week, 1, 3 and 6 months after surgery.

RESULTS: The groups did not differ in subjective and objective refraction. But there was significant variability of data in the group I 3 and 6 months after surgery. There was no difference in corneal astigmatism in both groups during 3 months, but a significant increase was found in group II 6 months after surgery. There was no difference in IOL tilt between groups before surgery. Decrease of IOL tilt in 180 degrees plane was observed after 1 month in group II, while there was no difference in 90 degrees plane between groups.

CONCLUSIONS: Both methods of late “in-the-bag” IOL dislocation treatment allow to receive good refractive result, but refraction is less predictable after trans-scleral suture IOL fixation. Surgically induced astigmatism is higher in IOL exchange group due to large sclerocorneal tunnel incision. Transscleral suture IOL fixation does not cause clinically significant IOL tilt.

Keywords

IOL dislocation / AS-OCT / IOL exchange / IOL fixation / IOL tilt

References

[1] Klein R, Klein BE. The prevalence of age-related eye diseases and visual impairment in aging: current estimates. Invest Ophthalmol Vis Sci. 2013;54(14): ORSF5-ORSF13. DOI: 10.1167/iovs.13-12789

[2] Klein R., Klein B.E. The prevalence of age-related eye diseases and visual impairment in aging: current estimates // Invest Ophthalmol Vis Sci. 2013. Vol. 54, No. 14. P. ORSF5-ORSF13. DOI: 10.1167/iovs.13-12789

[3] Kristianslund O, Dalby M, Drolsum L. Late in-the-bag intraocular lens dislocation. J Cataract Refract Surg. 2021;47(7):942–954. DOI: 10.1097/j.jcrs.0000000000000605

[4] Kristianslund O., Dalby M., Drolsum L. Late in-the-bag intraocular lens dislocation // J Cataract Refract Surg. 2021. Vol. 47, No. 7. P. 942–954. DOI: 10.1097/j.jcrs.0000000000000605

[5] Davis D, Brubaker J, Espandar L, et al. Late in-the-bag spontaneous intraocular lens dislocation: evaluation of 86 consecutive cases. Ophthalmology. 2009;116(4):664–670. DOI: 10.1016/j.ophtha.2008.11.018

[6] Davis D., Brubaker J., Espandar L., et al. Late in-the-bag spontaneous intraocular lens dislocation: evaluation of 86 consecutive cases // Ophthalmology. 2009. Vol. 116, No. 4. P. 664–670. DOI: 10.1016/j.ophtha.2008.11.018

[7] Gross JG, Kokame GT, Weinberg DV. Dislocated in-the-bag intraocular lens study group. In-the-bag intraocular lens dislocation. Am J Ophthalmol. 2004;137(4):630–635. DOI: 10.1016/j.ajo.2003.10.037

[8] Gross J.G., Kokame G.T., Weinberg D.V. Dislocated in-the-bag intraocular lens study group. In-the-bag intraocular lens dislocation // Am J Ophthalmol. 2004. Vol. 137, No. 4. P. 630–635. DOI: 10.1016/j.ajo.2003.10.037

[9] Hirata A, Okinami S, Hayashi K. Occurrence of capsular delamination in the dislocated in-the-bag intraocular lens. Graefe’s Arch Clin Exp Ophthalmol. 2011;249(9):1409–1415. DOI: 10.1007/s00417-010-1605-5

[10] Hirata A., Okinami S., Hayashi K. Occurrence of capsular delamination in the dislocated in-the-bag intraocular lens // Graefe’s Arch Clin Exp Ophthalmol. 2011. Vol. 249, No. 9. P. 1409–1415. DOI: 10.1007/s00417-010-1605-5

[11] Fernández-Buenaga R, Alio JL, Pérez-Ardoy AL, et al. Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes. Eye (Lond). 2013;27(7):795–802. DOI: 10.1038/eye.2013.95

[12] Fernández-Buenaga R., Alio J.L., Pérez-Ardoy A.L., et al. Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes // Eye (Lond). 2013. Vol. 27, No. 7. P. 795–802. DOI: 10.1038/eye.2013.95

[13] Potemkin VV, Astakhov SYu, Goltsman EV, Van SYu. Assessment of risk factors for the development of late intraocular lens dislocation. Ophthalmology in Russia. 2021;18(1):103–109. (In Russ.) DOI: 10.18008/1816-5095-2021-1-103-109

[14] Потемкин В.В., Астахов С.Ю., Гольцман Е.В., Ван С.Ю. Оценка факторов риска развития поздней дислокации интраокулярной линзы // Офтальмология. 2021. Т. 18, № 1. С. 103–109. DOI: 10.18008/1816-5095-2021-1-103-109

[15] Conway RM, Schlötzer-Schrehardt U, Küchle M, Naumann G. Pseudoexfoliation syndrome: Pathologic manifestations of relevance to intraocular surgery. Clin Exp Ophthalmol. 2004;32(2):199–210. DOI: 10.1111/j.1442-9071.2004.00806.x

[16] Conway R.M., Schlötzer-Schrehardt U., Küchle M., Naumann G. Pseudoexfoliation syndrome: Pathologic manifestations of relevance to intraocular surgery // Clin Exp Ophthalmol. 2004. Vol. 32, No. 2. P. 199–210. DOI: 10.1111/j.1442-9071.2004.00806.x

[17] Hayashi K, Hirata A, Hayashi H. Possible predisposing factors for in-the-bag and out-of-the-bag intraocular lens dislocation and outcomes of intraocular lens exchange surgery. Ophthalmology. 2007;114(5):969–975. DOI: 10.1016/j.ophtha.2006.09.017

[18] Hayashi K., Hirata A., Hayashi H. Possible predisposing factors for in-the-bag and out-of-the-bag intraocular lens dislocation and outcomes of intraocular lens exchange surgery // Ophthalmology. 2007. Vol. 114, No. 5. P. 969–975. DOI: 10.1016/j.ophtha.2006.09.017

[19] Eum SJ, Kim MJ, Kim HK. A comparison of clinical outcomes of dislocated intraocular lens fixation between in situ refixation and conventional exchange technique combined with vitrectomy. J Ophthalmol. 2016;2016:5942687. DOI: 10.1155/2016/5942687

[20] Eum S.J., Kim M.J., Kim H.K. A comparison of clinical outcomes of dislocated intraocular lens fixation between in situ refixation and conventional exchange technique combined with vitrectomy // J Ophthalmol. 2016. Vol. 2016. ID5942687. DOI: 10.1155/2016/5942687

[21] Rey A, Jürgens I, Dyrda A, et al. Surgical outcome of late in-the-bag intraocular lens dislocation treated with pars plana vitrectomy. Retina. 2016;36(3):576–581. DOI: 10.1097/IAE.0000000000000738

[22] Rey A., Jürgens I., Dyrda A., et al. Surgical outcome of late in-the-bag intraocular lens dislocation treated with pars plana vitrectomy // Retina. 2016. Vol. 36, No. 3. P. 576–581. DOI: 10.1097/IAE.0000000000000738

[23] Pashtaev NP. Klassifikatsiya dislokatsii khrustalika, sovremennaya taktika lecheniya. Aktual’nye problemy khirurgii khrustalika, steklovidnogo tela i setchatki. Moscow, 1986. P. 34–37. (In Russ.)

[24] Паштаев Н.П. Классификация дислокаций хрусталика, современная тактика лечения. Актуальные проблемы хирургии хрусталика, стекловидного тела и сетчатки. Москва, 1986. С. 34–37.

[25] Patent RUS № 2683932/02.04.2019. Byul. № 10. Pashtaev NP, Timofeeva NS, Kulikov IV, Pikusova SM. Sposob opredeleniya polozheniya intraokulyarnoi linzy. (In Russ.)

[26] Патент РФ на изобретение № 2683932/02.04.2019. Бюл. № 10. Паштаев Н.П., Тимофеева Н.С., Куликов И.В., Пикусова С.М. Способ определения положения интраокулярной линзы.

[27] Choi EY, Lee CH, Kang HG, et al. Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation. Sci Rep. 2021;11(1):726. DOI: 10.1038/s41598-020-80292-3

[28] Choi E.Y., Lee C.H., Kang H.G., et al. Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation // Sci Rep. 2021. Vol. 11, No. 1. ID 726. DOI: 10.1038/s41598-020-80292-3

[29] Kemer Atik B, Altan C, Agca A, et al. The effect of intraocular lens tilt on visual outcomes in scleral-fixated intraocular lens implantation. Int Ophthalmol. 2020;40(3):717–724. DOI: 10.1007/s10792-019-01233-2

[30] Kemer Atik B., Altan C., Agca A., et al. The effect of intraocular lens tilt on visual outcomes in scleral-fixated intraocular lens implantation // Int Ophthalmol. 2020. Vol. 40, No. 3. P. 717–724. DOI: 10.1007/s10792-019-01233-2

[31] Kristianslund O, Østern AE, Drolsum L. Astigmatism and refractive outcome after late in-the-bag intraocular lens dislocation surgery: A randomized clinical trial. Invest Ophthalmol Vis Sci. 2017;58(11):4747–4753. DOI: 10.1167/iovs.17-22723

[32] Kristianslund O., Østern A.E., Drolsum L. Astigmatism and refractive outcome after late in-the-bag intraocular lens dislocation surgery: A randomized clinical trial // Invest Ophthalmol Vis Sci. 2017. Vol. 58, No. 11. P. 4747–4753. DOI: 10.1167/iovs.17-22723

[33] Dalby M, Kristianslund O, Drolsum L. Long-term outcomes after surgery for late in-the-bag intraocular lens dislocation: A randomized clinical trial. Am J Ophthalmol. 2019;207:184–194. DOI: 10.1016/j.ajo.2019.05.030

[34] Dalby M., Kristianslund O., Drolsum L. Long-term outcomes after surgery for late in-the-bag intraocular lens dislocation: A randomized clinical trial // Am J Ophthalmol. 2019. Vol. 207. P. 184–194. DOI: 10.1016/j.ajo.2019.05.030

[35] Kristianslund O, Råen M, Østern AE, Drolsum L. Late in-the-bag intraocular lens dislocation: a randomized clinical trial comparing lens repositioning and lens exchange. Ophthalmology. 2017;124(2): 151–159. DOI: 10.1016/j.ophtha.2016.10.024

[36] Kristianslund O., Råen M., Østern A.E., Drolsum L. Late in-the-bag intraocular lens dislocation: a randomized clinical trial comparing lens repositioning and lens exchange // Ophthalmology. 2017. Vol. 124, No. 2. P. 151–159. DOI: 10.1016/j.ophtha.2016.10.024

[37] Ashena Z, Maqsood S, Ahmed SN, Nanavaty MA. Effect of intraocular lens tilt and decentration on visual acuity, dysphotopsia and wavefront aberrations. Vision (Basel). 2020;4(3):41. DOI: 10.3390/vision4030041

[38] Ashena Z., Maqsood S., Ahmed S.N., Nanavaty M.A. Effect of intraocular lens tilt and decentration on visual acuity, dysphotopsia and wavefront aberrations // Vision (Basel). 2020. Vol. 4, No. 3. ID 41. DOI: 10.3390/vision4030041

RIGHTS & PERMISSIONS

Eco-Vector