Surgical management and outcomes of dislocated intraocular lenses

Objective: To evaluate the surgical management and visual acuity outcomes in a large series of patients with dislocated intraocular lenses (IOLs). Design: Retrospective consecutive noncomparative case series. Participants: All patients who underwent surgical management of dislocated IOLs by two vitreoretinal surgeons at one institution between January 1, 1991, and March 31, 1998. Methods: Demographic and clinical data were abstracted from patients' medical records. Main Outcome Measures: Visual acuity at final follow-up and surgical complications. Results: The study population consisted of 110 patients, with a median follow-up interval of 50 weeks after dislocated IOL management. Surgical techniques included IOL repositioning in 93 (84.5%) eyes, IOL exchange in 16 (14.5%) eyes, and IOL removal in 1 (1%) eye. Final visual acuity was ≥20/40 in 63 patients (57%) patients, 20/50-20/200 in 34 (31%) patients, and <20/200 in 13 (12%) patients. Ninety-nine (90%) patients had stable or improved final vision. Observed complications included postoperative retinal detachment in 7 (6.3%) eyes, chronic cystoid macular edema in 19 (17%) eyes, and suprachoroidal hemorrhage in 1 (1%) eye. Conclusions: Surgical management of dislocated IOLs usually results in satisfactory visual outcomes. Pre-existing ocular pathology and postoperative complications may limit final vision. (C) 2000 by the American Academy of Ophthalmology.