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. 2023 Apr;43(4):1317-1324.
doi: 10.1007/s10792-022-02529-6. Epub 2022 Sep 23.

Intraocular lens dislocation: manifestation, ocular and systemic risk factors

Jana Catharina Riedl  1 , Severin Rings  2 , Alexander K Schuster  2 , Urs Vossmerbaeumer  2
Affiliations

Intraocular lens dislocation: manifestation, ocular and systemic risk factors

Jana Catharina Riedl et al. Int Ophthalmol. 2023 Apr.

Abstract

Purpose: The aim of this study was to evaluate ocular and systemic risk factors for posterior chamber intraocular lens dislocation, as well as forms of manifestation.

Methods: A retrospective case-control study were all patients presented in the period 2012-2016 having intraocular lens dislocation and being treated with implantation of an iris-fixated intraocular lens was conducted at the University Hospital Mainz. As controls, pseudophakic patients presenting for other reasons were included.

Results: 150 eyes of 150 patients (mean age 72.7 ± 12.4 years, range 24-93 years) with IOL dislocation and 150 eyes of 103 controls were included in this study. The average time between primary implantation and IOL luxation was 86 months (iQR: 39.25-127 months) for all dislocations. Previous pars plana vitrectomy (PPV) (crudeOR = 2.14 (95% CI 1.23, 3.72), p = 0.011) and PEX (crudeOR = 11.6 (4.79, 28.12), p < 0.001) was linked with a higher risk of IOL luxation. Luxation occurs also earlier in patients with previous PPV and PEX than in eyes with neither PEX nor previous PPV (82.2 vs. 127 months). Rhegmatogenous retinal detachment was the major pathology that required a previous PPV for eyes with an IOL dislocation (57%). The average time between PPV and IOL dislocation was 74.67 months (range 0-186 months).

Conclusion: Patients with a coexistence of both: PEX and a previous PPV had an elevated risk of IOL dislocation, and also had a shorter time interval between primary IOL implantation and IOL dislocation followed by eyes with PEX only and eyes with only a previous PPV.

Keywords: Intraocular lens; Intraocular lens dislocation; OCT; Pars plana vitrectomy; Secondary lens implantation.

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Conflict of interest statement

Riedl JC, Rings S, Vossmerbaeumer U declare they have no financial interests. Schuster AK receives research support from Allergan, Bayer, Heidelberg Engineering, PlusOptix and Norvartis. No funding was received with the preparation of this manuscript and for conducting this study. The authors declare that they have no competing interests that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Time (months) between primary Cataract Surgery and IOL dislocation
Fig. 2
Fig. 2
Time between primary Cataract Surgery and IOL dislocation according to the type of luxation
Fig. 3
Fig. 3
Time (months) between pars plana Vitrectomy and IOL dislocation (study group)
Fig. 4
Fig. 4
Kaplan–Meier curve. Patients with both -previous pars plana vitrectomy and PEX- are most likely to develop an IOL luxation at an early stage (group 4). In contrast, patients without this both risk factors are less likely for an IOL luxation (group 1)
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