Which surgical approach is better for late in-the-bag IOL dislocation?
Intraocular inflammation levels were similar after intraocular lens (IOL) repositioning and IOL exchange in patients with late in-the-bag IOL dislocation, according to a study.
In this prospective, randomized, parallel-group clinical trial, 100 patients (100 eyes) with late in-the-bag IOL dislocation were randomly assigned into IOL repositioning by scleral suturing (n = 49) or IOL exchange with retropupillary fixation of an iris-claw lens (n = 51).
At 2-weeks post-operation, the median flare values were 28.9 pc/ms and 31.6 pc/ms in the repositioning group and the exchange group, respectively.
After 6 weeks, flare levels were still similarly elevated in both groups but decreased to baseline levels after 6 months. Central retinal thickness was similar in both groups at 6 weeks.
In the IOL repositioning group, cystoid macular edema (CME) was found in 4 patients and the mean best-corrected visual acuity was 0.17 logarithm of the minimum angle of resolution. In the IOL exchange CME was found in 5 patients and the mean best-corrected visual acuity was 0.21 logarithm of the minimum angle of resolution.
Medin H, Dalby M, Slordahl Hjort Kure I, et al. Intraocular inflammation in eyes operated for Late In-the-bag intraocular lens dislocation: A randomized clinical trial. Am J Ophthalmol. 2022;DOI:https://doi.org/10.1016/j.ajo.2021.12.019