Late in-the-bag spontaneous IOL dislocation: risk factors and surgical outcomes
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摘要
AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries.METHODS: Medical and surgical records of 39 eyes of 39 patients who underwent IOL repositioning or exchange surgery for dislocation between 2010 and 2018 were reviewed. Possible predisposing risk factors and some characteristics of late in-the-bag spontaneous IOL dislocations; outcomes of IOL repositioning and exchange surgeries, including visual acuity, refractive status before and after surgery and postoperative complications were evaluated.RESULTS: The predisposing factors for late in-the-bag spontaneous IOL dislocations were pseudoexfoliation [PEX; 12/39(30.8%)], previous vitreoretinal surgery [7/39(17.9%)], axial myopia [3/39(7.7%)], both PEX and axial myopia [1/39(2.6%)], both previous vitreoretinal surgery and axial myopia [2/39(5.1%)] and uveitis [1/39(2.6%)]. The mean interval between cataract and dislocation surgery was 7.23 y, greater in PEX positive group(8.63 y). The mean best corrected visual acuity(BCVA) improved significantly after dislocation surgery(P<0.001) and also improved significantly after exchange surgery(P=0.001). The mean value of spherical equivalant decreased significantly after dislocation surgery(P=0.011), whereas corneal astigmatism increased but this difference was not significant after dislocation surgery and exchange surgery(P=0.191, P=0.074, respectively).CONCLUSION: The most prevelant risk factors for late inthe-bag spontaneous IOL dislocations are PEX, previous vitreoretinal surgery and axial myopia. In the management of IOL dislocations, exchange surgery with small corneal incision seemed effective with improved BCVA and safety with low postoperative complications.
AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries.METHODS: Medical and surgical records of 39 eyes of 39 patients who underwent IOL repositioning or exchange surgery for dislocation between 2010 and 2018 were reviewed. Possible predisposing risk factors and some characteristics of late in-the-bag spontaneous IOL dislocations; outcomes of IOL repositioning and exchange surgeries, including visual acuity, refractive status before and after surgery and postoperative complications were evaluated.RESULTS: The predisposing factors for late in-the-bag spontaneous IOL dislocations were pseudoexfoliation [PEX; 12/39(30.8%)], previous vitreoretinal surgery [7/39(17.9%)], axial myopia [3/39(7.7%)], both PEX and axial myopia [1/39(2.6%)], both previous vitreoretinal surgery and axial myopia [2/39(5.1%)] and uveitis [1/39(2.6%)]. The mean interval between cataract and dislocation surgery was 7.23 y, greater in PEX positive group(8.63 y). The mean best corrected visual acuity(BCVA) improved significantly after dislocation surgery(P<0.001) and also improved significantly after exchange surgery(P=0.001). The mean value of spherical equivalant decreased significantly after dislocation surgery(P=0.011), whereas corneal astigmatism increased but this difference was not significant after dislocation surgery and exchange surgery(P=0.191, P=0.074, respectively).CONCLUSION: The most prevelant risk factors for late inthe-bag spontaneous IOL dislocations are PEX, previous vitreoretinal surgery and axial myopia. In the management of IOL dislocations, exchange surgery with small corneal incision seemed effective with improved BCVA and safety with low postoperative complications.
AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries.METHODS: Medical and surgical records of 39 eyes of 39 patients who underwent IOL repositioning or exchange surgery for dislocation between 2010 and 2018 were reviewed. Possible predisposing risk factors and some characteristics of late in-the-bag spontaneous IOL dislocations; outcomes of IOL repositioning and exchange surgeries, including visual acuity, refractive status before and after surgery and postoperative complications were evaluated.RESULTS: The predisposing factors for late in-the-bag spontaneous IOL dislocations were pseudoexfoliation [PEX; 12/39(30.8%)], previous vitreoretinal surgery [7/39(17.9%)], axial myopia [3/39(7.7%)], both PEX and axial myopia [1/39(2.6%)], both previous vitreoretinal surgery and axial myopia [2/39(5.1%)] and uveitis [1/39(2.6%)]. The mean interval between cataract and dislocation surgery was 7.23 y, greater in PEX positive group(8.63 y). The mean best corrected visual acuity(BCVA) improved significantly after dislocation surgery(P<0.001) and also improved significantly after exchange surgery(P=0.001). The mean value of spherical equivalant decreased significantly after dislocation surgery(P=0.011), whereas corneal astigmatism increased but this difference was not significant after dislocation surgery and exchange surgery(P=0.191, P=0.074, respectively).CONCLUSION: The most prevelant risk factors for late inthe-bag spontaneous IOL dislocations are PEX, previous vitreoretinal surgery and axial myopia. In the management of IOL dislocations, exchange surgery with small corneal incision seemed effective with improved BCVA and safety with low postoperative complications.
引文
1 Davison JA.Capsule contraction syndrome.J Cataract Refract Surg1993;19(5):582-589.
2 Gimbel HV,Condon GP,Kohnen T,Olson RJ,Halkiadakis I.Late in-the-bag intraocular lens dislocation:incidence,prevention,and management.J Cataract Refract Surg 2005;31(11):2193-2204.
3 Hayashi K,Hirata A,Hayashi H.Possible predisposing factors for inthe-bag and out-of-the-bag intraocular lens dislocation and outcomes of intraocular lens exchange surgery.Ophthalmology 2007;114(5):969-975.
4 B?ke WR,Krüger HC.Causes and management of posterior chamber lens displacement.J Am Intraocul Implant Soc 1985;11(2):179-184.
5 Jehan FS,Mamalis N,Crandall AS.Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients.Ophthalmology 2001;108(10):1727-1731.
6 Zech JC,Tanniére P,Denis P,Trepsat C.Posterior chamber intraocular lens dislocation with the bag.J Cataract Refract Surg 1999;25(8):1168-1169.
7 Yasuda A,Ohkoshi K,Orihara Y,Kusano Y,Sakuma A,Yamaguchi T.Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy,phacoemulsification,and intraocular lens implantation.Am J Ophthalmol 2000;130(6):836-837.
8 Hayashi K,Hayashi H,Matsuo K,Nakao F,Hayashi F.Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa.Ophthalmology 1998;105(7):1239-1243.
9 Cionni RJ.Surgical management of the congenitally subluxated crystalline lens using the modified capsular tension ring.In:Steinert RF,ed.Cataract Surgery:Technique,Complications,and Management.2nd ed.Philadelphia,PA:Saunders 2004:305-313.
10 Kr?p?t?L,Kuzmien?L,Miliauskas A,Janulevi?ien?I.Possible predisposing factors for late intraocular lens dislocation after routine cataract surgery.Medicina(Kaunas)2013;49(5):229-234.
11 Nikeghbali A,Falavarjani KG.Modified transscleral fixation technique for refixation of dislocated intraocular lenses.J Cataract Refract Surg2008;34(5):743-748.
12 Kaynak S,Ozbek Z,Pasa E,Oner FH,Cingil G.Transscleral fixation of foldable intraocular lenses.J Cataract Refract Surg 2004;30(4):854-857.
13 Davis D,Brubaker J,Espandar L,Stringham J,Crandall A,Werner L,Mamalis N.Late in-the-bag spontaneous intraocular lens dislocation:evaluation of 86 consecutive cases.Ophthalmology 2009;116(4):664-670.
14 Stark WJ Jr,Maumenee AE,Datiles M,Fagadau W,Baker CC,Worthen D,Auer C,Klein P,McGhee E,Jacobs ME.Intraocular lenses:complications and visual results.Trans Am Ophthalmol Soc 1983;81:280-309.
15 Kim SS,Smiddy WE,Feuer W,Shi W.Management of dislocated intraocular lenses.Ophthalmology 2008;115(10):1699-1704.
16 Jakobsson G,Zetterberg M,Lundstr?m M,Stenevi U,Grenmark R,Sundelin K.Late dislocation of in-the-bag and out-of-the bag intraocular lenses:ocular and surgical characteristics and time to lens repositioning.JCataract Refract Surg 2010;36(10):1637-1644.
17 Pueringer SL,Hodge DO,Erie JC.Risk of late intraocular lens dislocation after cataract surgery,1980-2009:a population-based study.Am J Ophthalmol 2011;152(4):618-623.
18 Fernández-Buenaga R,Alio JL,Pérez-Ardoy AL,Larrosa-Quesada A,Pinilla-Cortés L,Barraquer R,Alio JL 2nd,Mu?oz-Negrete FJ.Late inthe-bag intraocular lens dislocation requiring explantation:risk factors and outcomes.Eye(Lond)2013;27(7):795-801;quiz 802.
19 Conway RM,Schl?tzer-Schrehardt U,Küchle M,Naumann GO.Pseudoexfoliation syndrome:pathological manifestations of relevance to intraocular surgery.Clin Exp Ophthalmol 2004;32(2):199-210.
20 Zenkel M,P?schl E,von der Mark K,Hofmann-Rummelt C,Naumann GO,Kruse FE,Schl?tzer-Schrehardt U.Differential gene expression in pseudoexfoliation syndrome.Invest Ophthalmol Vis Sci2005;46(10):3742-3752.
21 Gross JG,Kokame GT,Weinberg DV;Dislocated In-The-Bag Intraocular Lens Study Group.In-the-bag intraocular lens dislocation.Am J Ophthalmol 2004;137(4):630-635.
22 Kristianslund O,R?en M,?stern AE,Drolsum L.Late in-the-bag intraocular lens dislocation:a randomized clinical trial comparing lens repositioning and lens exchange.Ophthalmology 2017;124(2):151-159.
23 M?nestam EI.Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery.Ophthalmology2009;116(12):2315-2320.
24 Lorente R,de Rojas V,Vazquez de Parga P,Moreno C,Landaluce ML,Domínguez R,Lorente B.Management of late spontaneous in-the-bag intraocular lens dislocation:Retrospective analysis of 45 cases.J Cataract Refract Surg 2010;36(8):1270-1282.
25?stern AE,Sandvik GF,Drolsum L.Late in-the-bag intraocular lens dislocation in eyes with pseudoexfoliation syndrome.Acta Ophthalmol2014;92(2):184-191.
26 Sarrafizadeh R,Ruby AJ,Hassan TS,Williams GA,Garretson BR,Trese MT,Margherio RR.A comparison of visual results and complications in eyes with posterior chamber intraocular lens dislocation treated with pars plana vitrectomy and lens repositioning or lens exchange.Ophthalmology 2001;108(1):82-89.
2 Gimbel HV,Condon GP,Kohnen T,Olson RJ,Halkiadakis I.Late in-the-bag intraocular lens dislocation:incidence,prevention,and management.J Cataract Refract Surg 2005;31(11):2193-2204.
3 Hayashi K,Hirata A,Hayashi H.Possible predisposing factors for inthe-bag and out-of-the-bag intraocular lens dislocation and outcomes of intraocular lens exchange surgery.Ophthalmology 2007;114(5):969-975.
4 B?ke WR,Krüger HC.Causes and management of posterior chamber lens displacement.J Am Intraocul Implant Soc 1985;11(2):179-184.
5 Jehan FS,Mamalis N,Crandall AS.Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients.Ophthalmology 2001;108(10):1727-1731.
6 Zech JC,Tanniére P,Denis P,Trepsat C.Posterior chamber intraocular lens dislocation with the bag.J Cataract Refract Surg 1999;25(8):1168-1169.
7 Yasuda A,Ohkoshi K,Orihara Y,Kusano Y,Sakuma A,Yamaguchi T.Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy,phacoemulsification,and intraocular lens implantation.Am J Ophthalmol 2000;130(6):836-837.
8 Hayashi K,Hayashi H,Matsuo K,Nakao F,Hayashi F.Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa.Ophthalmology 1998;105(7):1239-1243.
9 Cionni RJ.Surgical management of the congenitally subluxated crystalline lens using the modified capsular tension ring.In:Steinert RF,ed.Cataract Surgery:Technique,Complications,and Management.2nd ed.Philadelphia,PA:Saunders 2004:305-313.
10 Kr?p?t?L,Kuzmien?L,Miliauskas A,Janulevi?ien?I.Possible predisposing factors for late intraocular lens dislocation after routine cataract surgery.Medicina(Kaunas)2013;49(5):229-234.
11 Nikeghbali A,Falavarjani KG.Modified transscleral fixation technique for refixation of dislocated intraocular lenses.J Cataract Refract Surg2008;34(5):743-748.
12 Kaynak S,Ozbek Z,Pasa E,Oner FH,Cingil G.Transscleral fixation of foldable intraocular lenses.J Cataract Refract Surg 2004;30(4):854-857.
13 Davis D,Brubaker J,Espandar L,Stringham J,Crandall A,Werner L,Mamalis N.Late in-the-bag spontaneous intraocular lens dislocation:evaluation of 86 consecutive cases.Ophthalmology 2009;116(4):664-670.
14 Stark WJ Jr,Maumenee AE,Datiles M,Fagadau W,Baker CC,Worthen D,Auer C,Klein P,McGhee E,Jacobs ME.Intraocular lenses:complications and visual results.Trans Am Ophthalmol Soc 1983;81:280-309.
15 Kim SS,Smiddy WE,Feuer W,Shi W.Management of dislocated intraocular lenses.Ophthalmology 2008;115(10):1699-1704.
16 Jakobsson G,Zetterberg M,Lundstr?m M,Stenevi U,Grenmark R,Sundelin K.Late dislocation of in-the-bag and out-of-the bag intraocular lenses:ocular and surgical characteristics and time to lens repositioning.JCataract Refract Surg 2010;36(10):1637-1644.
17 Pueringer SL,Hodge DO,Erie JC.Risk of late intraocular lens dislocation after cataract surgery,1980-2009:a population-based study.Am J Ophthalmol 2011;152(4):618-623.
18 Fernández-Buenaga R,Alio JL,Pérez-Ardoy AL,Larrosa-Quesada A,Pinilla-Cortés L,Barraquer R,Alio JL 2nd,Mu?oz-Negrete FJ.Late inthe-bag intraocular lens dislocation requiring explantation:risk factors and outcomes.Eye(Lond)2013;27(7):795-801;quiz 802.
19 Conway RM,Schl?tzer-Schrehardt U,Küchle M,Naumann GO.Pseudoexfoliation syndrome:pathological manifestations of relevance to intraocular surgery.Clin Exp Ophthalmol 2004;32(2):199-210.
20 Zenkel M,P?schl E,von der Mark K,Hofmann-Rummelt C,Naumann GO,Kruse FE,Schl?tzer-Schrehardt U.Differential gene expression in pseudoexfoliation syndrome.Invest Ophthalmol Vis Sci2005;46(10):3742-3752.
21 Gross JG,Kokame GT,Weinberg DV;Dislocated In-The-Bag Intraocular Lens Study Group.In-the-bag intraocular lens dislocation.Am J Ophthalmol 2004;137(4):630-635.
22 Kristianslund O,R?en M,?stern AE,Drolsum L.Late in-the-bag intraocular lens dislocation:a randomized clinical trial comparing lens repositioning and lens exchange.Ophthalmology 2017;124(2):151-159.
23 M?nestam EI.Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery.Ophthalmology2009;116(12):2315-2320.
24 Lorente R,de Rojas V,Vazquez de Parga P,Moreno C,Landaluce ML,Domínguez R,Lorente B.Management of late spontaneous in-the-bag intraocular lens dislocation:Retrospective analysis of 45 cases.J Cataract Refract Surg 2010;36(8):1270-1282.
25?stern AE,Sandvik GF,Drolsum L.Late in-the-bag intraocular lens dislocation in eyes with pseudoexfoliation syndrome.Acta Ophthalmol2014;92(2):184-191.
26 Sarrafizadeh R,Ruby AJ,Hassan TS,Williams GA,Garretson BR,Trese MT,Margherio RR.A comparison of visual results and complications in eyes with posterior chamber intraocular lens dislocation treated with pars plana vitrectomy and lens repositioning or lens exchange.Ophthalmology 2001;108(1):82-89.