Late dislocation and haptic deformation of a hydrophilic intraocular lens: characteristics, incidence rates and predisposing factors

Session Details

Session Title: Cataract Surgery Complications/Management

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

Paper Time: 17:06

Venue: Auditorium C6

First Author: : C.Mayer AUSTRIA

Co Author(s): :    N. Hirnschall   W. Wackernagel   G. Pregartner   T. Falb   O. Findl   N. Ardjomand     

Abstract Details

Purpose:

To study characteristics and predisposing factors for late IOL dislocation and haptic bending of a single type of intraocular lens (IOL), calculate incidence rates and odds ratios for predisposing risk factors.

Setting:

Department of Ophthalmology Graz, Mecial University Graz, Graz, Austria.

Methods:

All patients with phacoemulsification and extracapsular cataract surgery with the hydrophilic acrylic IOL ACR6D SE at the Department of Ophthalmology Graz were included. Characteristics and predisposing factors for late in-the-bag, out-of-the-bag IOL dislocations, and haptic complications were investigated and compared amongst each other or control patients. Incidence rates for each IOL complication were calculated. For in-the-bag dislocations odds ratios for each predisposing factor were calculated.

Results:

Out of 10125 patients (12602 eyes), 44 patients (0.43%, 48 eyes) had a late in-the-bag dislocation, 7 (0.07%, 7 eyes) an out-of-the-bag dislocation, and 17 (0.17%, 18 eyes) a haptic bending complication. There were significantly less eyes without predisposing factors among in-the-bag dislocations compared to haptic complications (6/48 vs 13/18 eyes; p<0.001). Adjusted odds ratios (95% CI) for in-the-bag dislocations were 35.2 (17.5 – 73.5) for PXF, 19.7 (8.8 – 43.4) for relevant myopia, 27.5 (5.6 – 100.8) for uveitis, 13.9 (0.6 – 119.5) for RP and 2.0 (1.0 – 3.7) for male sex. Incidence rate for a late IOL dislocation was 0.49 per 1000 person-years (in-the-bag dislocations 0.42; out-of-the-bag dislocations 0.07 per 1000 person-years).

Conclusions:

PXF was the main risk factor for an in-the-bag dislocation, followed by relevant myopia, RP, and male sex. Incidence rates for IOL complications were low and seem to be mainly influenced by the prevalence of predisposing factors. The difference in the prevalence of predisposing factors between the in-the-bag dislocations and the haptic complications shows the importance of zonular weakness in the mechanism of in-the-bag dislocations.

Financial Disclosure:

NONE