Management of Dislocated IOLs

October’s Ophthalmology

A study by Kim et al. characterizing the management of dislocated IOLs indicates that dislocation most commonly involves foldable IOLs. Effective treatment techniques include IOL exchange or IOL repositioning with or without scleral suture fixation.
The investigators reviewed 284 eyes of 277 patients who underwent surgery for dislocated IOLs. Three-month follow-up data were gathered from 184 eyes. Dislocated lenses included PMMA IOLs, silicone-plate IOLs, three-piece silicone IOLs and acrylic IOLs. In-the-bag dislocations were associated with pseudoexfoliation and ocular trauma. Cystoid macular edema was the most common complication of a dislocated IOL. In 11 eyes, retinal detachment occurred after management of the dislocated IOL.
The authors caution that management approaches depend upon surgeon preferences and subspecialty, yet the wide range of treatment options allows surgeons to customize the optimal treatment approach for each patient.