Causes and risk factors for late luxation of IOL

Session Details

Session Title: Presented Poster Session: Cataract Complications & Special Cases

Venue: Poster Village: Pod 1

First Author: : J.Riedl GERMANY

Co Author(s): :    U. Vossmerbaeumer      .                  

Abstract Details

Purpose:

Late luxation of an IOL is known as a complication after cataract surgery causing loss of vision. Without appropriate surgery, not only optical disadvantages but also vitreoretinal complications may occur. The purpose of our study is to determine the causes and risk factors underlying spontaneous subluxation of intraocular lenses in long-term follow up.

Setting:

Retrospective controlled consecutive clinical case series, long-term follow up, Department of Ophthalmology, University Hospital Mainz

Methods:

All cases of patients presenting with partial or total luxation of an intraocular lens between 2012 and 2016 were retrospectively analyzed. Included parameters were type of IOL dislocation, type of IOL, initial surgical procedure, patient age, sex, medical history before and after cataract surgery with regard to comorbidity and ocular surgeries, biometry. A 1:3 age-matched control group was equally analyzed to identify particular risks in the study group.

Results:

301 patients were included in the study. Most frequent identfied causes for late in-the-bag IOL (sub)luxation in our cohort were pseudoexfoliation syndrome (n=78) and prior pars plana vitrectomy (n=71). 27 eyes had received a capsular tension ring as a sign of preexisting zonular disease. Out of the bag (sub)luxation followed mostly complicated initial cataract surgery. Most frequent method of secondary IOL fixation was implantation of an iris-fixated IOL (95%).

Conclusions:

Pseudoexfoliation (PEX) syndrome as well as post-cataract surgery pars plana vitrectomy appear to represent the major risk factors for the event of IOL luxation. While in PEX, zonular fibres gradually lose elasticity and stability due to disease progression, shaving of the vitreous base with damage to the posteriorly inserting zonules seems to equally destabilize the capsular bag. Reducing the amount of shaving in pars plana vitrectomy may prevent subsequent IOL luxation.

Financial Disclosure:

None