A randomised controlled trial comparing two operation methods for late in-the-bag intraocular lens dislocation

Session Details

Session Title: Cataract Surgery Complications/Management

Session Date/Time: Monday 12/09/2016 | 16:30-18:15

Paper Time: 16:36

Venue: Auditorium C6

First Author: : O.Kristianslund NORWAY

Co Author(s): :    L. Drolsum                    

Abstract Details

Purpose:

To prospectively compare two operation methods for late in-the-bag intraocular lens (IOL) dislocation in a randomised controlled trial.

Setting:

Department of Ophthalmology at Oslo University Hospital (Norway).

Methods:

One hundred and three patients that were eligible to both operation methods were randomised (1:1) to either repositioning of the IOL with scleral suturing or exchanging the IOL with a retropupillary fixated iris-claw lens (Verisyse® Phakic IOL; Abbott Laboratories Inc., Illinois, USA). One surgeon (L.D.) performed all the operations. Mean patient age was 82±9 years in the IOL repositioning group and 82±6 years in the IOL exchange group (p=0.66), and the gender distribution (male/female) was 35%/65% and 41%/59%, respectively (p=0.49). The patients had a thorough examination before surgery and 6 months postoperatively.

Results:

Both groups experienced a significant improvement in corrected distance visual acuity (CDVA) postoperatively (p=0.03), with no significant difference between the groups (p=0.21). Approximately 60% of the study patients in both groups reached a postoperative CDVA (Snellen) of ≥20/40. Significantly more patients in the IOL repositioning group had intraocular haemorrhage compared to the IOL exchange group (p<0.01). On the contrary, perioperative iris injury and the requirement for anterior vitrectomy were more common in the IOL exchange group (p=0.01 and p<0.001, respectively).

Conclusions:

To our knowledge this is the first randomised controlled clinical trial on late in-the-bag IOL dislocation surgery. We found that visual outcome 6 months after surgery was satisfactory, and not significantly different in eyes operated with IOL repositioning compared to eyes operated with IOL exchange.

Financial Disclosure:

NONE