Posters

Late in-the-bag intraocular lens luxation into vitreous cavity: predisposing factors and visual outcomes

Poster Details

First Author: J. Coelho PORTUGAL

Co Author(s):    P. Meneres   N. Correia   B. Pessoa   J. Melo Beirao   N. Ferreira   A. Meireles     

Abstract Details

Purpose:

Posterior chamber intraocular lens (IOL) luxation is uncommon but represents one of the most serious complications following phacoemulsification. Late in-the-bag IOL dislocation is defined as occurring three months or later following cataract surgery. In recent years, this late complication of cataract surgery has been reported with increasing frequency. The purpose of this study is to analyse the predisposing factors, visual outcomes and postoperative complications of pars plana vitrectomy (PPV) for late in-the-bag intraocular lenses (IOL) luxation into the vitreous cavity.

Setting:

Department of Ophthalmology of a tertiary referral centre in Oporto, Portugal - Centro Hospitalar do Porto

Methods:

Retrospective case series analysis of 27 eyes - 25 patients – with late in-the-bag IOL luxation into the vitreous cavity who had undergone a pars plana vitrectomy and IOL recolocation, exchange, or removal between January 2014 and December 2015. The main outcome measures were predisposing factors for luxation, time between cataract surgery and luxation, preoperative and postoperative best corrected visual acuity (BCVA) and postoperative complications.

Results:

27 eyes of 25 patients were analysed. Mean age was 74,4 years (57-91). Mean time between cataract surgery and PPV was 8,8 years. Main predisposing factors were pseudoexfoliation (44,4%) and previous vitrectomy (29,6%). In 40,7% of eyes, the luxated IOL were recolocated with scleral fixation and in 25,9% the IOL was exchanged to a scleral-fixated foldable posterior chamber IOL. An iris-supported anterior chamber IOL was implanted in 26,2% of cases. Removal of IOL was done in two cases and eyes became aphakic. Mean BCVA improves significantly after surgery (P=0.001). During the follow-up, two cases of corneal endothelial descompensation and one retinal detachment were reported.

Conclusions:

Pseudoexfoliation was the main risk factor identified in our sample for late in-the-bag IOL dislocation. Repositioning of the preexisting IOL using scleral suturing was the surgical option in most cases and appears to be a safe and effective technique for restoring visual acuity. BCVA significantly improved in our sample however more cases are necessary to evaluate the best surgical technique and the incidence of this late complication of cataract surgery.

Financial Disclosure:

NONE