[Risk of dislocation and cataract formation in 240 IOGEL lenses. 4 years experiences]

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Materials Science

Background:

• Cataract surgery involves implanting intraocular lenses (IOLs) to restore vision.
• IOGEL lenses are a type of foldable IOL implanted into the capsular bag.
• Complications such as IOL dislocation can impact visual outcomes.

Purpose of the Study:

• To evaluate the incidence and reasons for IOGEL lens dislocation after extracapsular cataract extraction.
• To identify risk factors associated with IOGEL lens instability.
• To provide recommendations for preventing IOL dislocation.

Main Methods:

• Prospective study of 240 patients undergoing cataract surgery with IOGEL lens implantation.
• Analysis of IOL dislocation events, including timing, associated procedures (e.g., Nd-YAG capsulotomy), and patient factors.
• Review of surgical records and patient outcomes.

Main Results:

• Five of 240 IOGEL lenses dislocated into the vitreous cavity.
• Dislocations occurred postoperatively, after Nd-YAG capsulotomy, and after surgical repositioning.
• Secondary cataract formation requiring Nd-YAG capsulotomy was noted in 33 patients.
• Capsular shrinkage and large capsular openings were identified as contributing factors to late dislocation.
• Eight patients required secondary anterior chamber lens implantation, with three explantations.

Conclusions:

• Primary stable placement of IOGEL lenses in the capsular bag is achievable.
• Late IOGEL lens dislocation can occur due to lack of adhesion to capsular sheets and postoperative capsular shrinkage.
• Recommendations include delaying Nd-YAG capsulotomy until at least 6 months postoperatively, limiting its diameter to 4 mm, and avoiding IOGEL implantation in cases of intraoperative capsular rupture.