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Outcomes and Determinants of Posterior Dislocated Intraocular Lens Management at a Tertiary Eye Hospital in Central
Mohammad A Hazzazi1,2, Saba Al Rashaed1,3
1Vitreoretina Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Purpose:
The aim of this study is to evaluate the determinants of visual outcomes, complications after managing the posterior dislocated intraocular lens (IOL).
Methods:
Patients with posterior dislocated IOL managed between 2002 and 2016 in our institute were reviewed. Ocular status and causes for dislocation were noted. Success was defined as uncorrected visual acuity (UCVA) of 20/20-20/200 at the last follow-up. The risk factors were associated with the success.
Results:
Of the 79 eyes with posterior dislocated IOL, 40 (50.6%) eyes had vision <20/400 at presentation. Glaucoma and retinal detachment were present in 12 (15.2%) and 5 (6.3%) eyes. IOL was removed from 33 (41.8%) eyes. Secondary IOL was implanted in 25 (31.6%) eyes, and IOL was repositioned in 19 (24.1%) eyes. The median duration of follow-up was 2.1 years. The final UCVA was "20/20-20/60" and ">20/200" in 45 (57%) and 14 (17.7%) eyes. The main causes of Severe visual impairment (SVI) included glaucoma (5), corneal decompensation (5), retinal detachment (4), and macular edema (3). Young age (P = 0.02), late IOL dislocation (P = 0.005), primary IOL implant (P < 0.01), SVI (P = 0.09), IOL removal (P = 0.06), and no glaucoma at presentation were significantly associated to the success. Late IOL dislocation (P = 0.05) and no glaucoma (P = 0.05) were independently associated to the success.
Conclusion:
The management of the dislocation of IOL had promising visual outcomes. Glaucoma and early dislocation predict poor vision after dislocated IOL management. Close monitoring is needed to manage complications.