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.

Reference
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