Repositioned versus exchanged flanged intraocular lens fixation for intraocular lens dislocation

Area of Science:

• Ophthalmology
• Surgical Techniques
• Intraocular Lens Implantation

Background:

• Intraocular lens (IOL) dislocation is a significant complication following cataract surgery.
• Flanged IOL fixation is a technique used to manage dislocated IOLs.
• Comparing management strategies for dislocated IOLs is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the outcomes of flanged intraocular lens (IOL) fixation using new IOL exchange versus repositioning a dislocated IOL.
• To evaluate visual acuity, IOL position, and corneal health in patients undergoing these procedures.

Main Methods:

• Retrospective study including 89 eyes with flanged IOL fixation for IOL dislocation.
• Patients were divided into two groups: new IOL exchange (51 eyes) and repositioned dislocated IOL (38 eyes).
• Outcomes assessed included best-corrected visual acuity (BCVA), IOL tilt, IOL decentration, corneal endothelial cell density (ECD), and corneal astigmatism.

Main Results:

• Both groups showed improved BCVA postoperatively, with no significant difference at 1, 3, 6, or 12 months.
• The repositioned IOL group showed earlier BCVA improvement at 1 week compared to the exchanged IOL group.
• The repositioned IOL group experienced lesser decreases in corneal ECD and corneal astigmatism compared to the exchanged IOL group.
• IOL tilt and decentration were similar between the two groups.

Conclusions:

• Flanged IOL fixation with either new IOL exchange or repositioning of the dislocated IOL yields comparable visual outcomes and IOL stability.
• Repositioning the dislocated IOL with flanged fixation offers an advantage by minimizing corneal endothelial cell loss and astigmatic changes.
• This approach is effective for treating IOL dislocation while preserving corneal integrity.