Clinical Features, Risk Factors, and Outcomes Following Surgery for Late Intraocular Lens Decentration in the Dead...

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Late intraocular lens (IOL) decentration and dislocation can occur due to spontaneous posterior capsule rupture, a condition termed "dead bag syndrome."
• This syndrome necessitates surgical intervention for visual rehabilitation.

Purpose of the Study:

• To analyze the demographic profile, identify risk factors, and evaluate outcomes of IOL exchange surgery for late decentration in dead bag syndrome.
• To assess the efficacy of the Yamane technique for intrascleral fixation of a 3-piece foldable IOL in these cases.

Main Methods:

• A prospective, interventional case series involving 46 eyes (43 patients) with late IOL decentration/dislocation and posterior capsule rupture.
• Surgical procedure included IOL explantation, pars plana vitrectomy, and intrascleral fixation of a new IOL using the Yamane technique.

Main Results:

• The majority of patients were male (91%) with a mean age of 68.7 years; axial myopia was prevalent (>50%).
• 87% of eyes showed improved corrected-distance visual acuity (CDVA) post-surgery, with 95% achieving CDVA ≤0.3 logMAR.
• Common complications included transient IOP spike (17%) and cystoid macular edema (13%).

Conclusions:

• Male sex, axial myopia, and prolonged duration post-cataract surgery are significant risk factors for dead bag syndrome.
• The presence of a Soemmering ring and bilaterality were noted as potential new observations requiring further investigation.
• IOL exchange surgery using the Yamane technique yielded satisfactory visual outcomes in patients with dead bag syndrome.