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J Cataract Refract SurgJuly 201354 citations

Management and outcomes of intraocular lens dislocation in patients with pseudoexfoliation.

Shingleton Bradford J, Yang Yang, O'Donoghue Mark W


AI Summary

This study found that surgical repair of dislocated IOLs in pseudoexfoliation patients significantly improved vision and lowered IOP, with stable glaucoma medication needs and good outcomes regardless of IOL exchange or repositioning.

Abstract

Purpose

To analyze the outcomes of surgery for dislocated intraocular lenses (IOLs) in patients with pseudoexfoliation (PXF).

Setting

Private practice, Boston, Massachusetts, USA.

Design

Retrospective case study.

Methods

Eyes with PXF and IOL dislocations that had IOL exchange or repositioning were reviewed. An outcomes analysis compared the surgical techniques with regard to corrected distance visual acuity (CDVA), intraocular pressure (IOP), and glaucoma medication requirements.

Results

The IOL exchange was performed in 64 eyes (79%) and IOL repositioning in 17 eyes (21%). The CDVA improved in all eyes, from a preoperative mean of 0.78 logMAR ± 0.50 (SD) to a mean of 0.35 ± 0.31 logMAR at the final follow-up (mean 2.5 ± 2.6 years) (P<.0001). The mean IOP was reduced by 4.2 mm Hg at the final follow-up (P<.0001). The mean glaucoma medication requirement remained stable at the final follow-up compared with the preoperative levels (P>.05). There were no significant differences in the mean CDVA, IOP, or glaucoma medication requirement between eyes that had IOL exchange and eyes that had IOL repositioning. There were no significant intraoperative complications. The most common postoperative complication was a transient decrease in IOP to 5 mm Hg or lower or an increase in IOP to 30 mm Hg or higher.

Conclusions

Patients with PXF having surgical treatment of IOL dislocation have the potential for excellent visual outcomes with minimal intraoperative and postoperative complications.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.


MeSH Terms

Aged, 80 and overArtificial Lens Implant MigrationExfoliation SyndromeFemaleHumansIntraocular PressureIrisLens Implantation, IntraocularMaleReoperationRetrospective StudiesScleraSurgical FlapsSuture TechniquesTreatment OutcomeVisual Acuity

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