Risk factors of late intraocular Lens displacement: A multi-national study

Area of Science:

• Ophthalmology and Vision Science
• Surgical Complications
• Intraocular Lens Technology

Background:

• Late intraocular lens displacement (LIOLD) is a rare but significant complication following cataract surgery.
• It is often attributed to progressive zonular insufficiency and may require pars plana vitrectomy (PPV) and intraocular lens (IOL) exchange for management.
• Understanding the risk factors is crucial for prevention and improved patient outcomes.

Purpose of the Study:

• To investigate and identify significant risk factors associated with the development of late intraocular lens displacement (LIOLD).
• To analyze demographic, biometry, and medical history data to pinpoint predictors of LIOLD.
• To contribute multinational data to the understanding of LIOLD etiology.

Main Methods:

• A retrospective case-control study was conducted across 16 centers in the UK, Germany, and Greece.
• Cases of LIOLD between June 2018 and January 2023 were identified and compared with a control group (20,321 eyes).
• Multivariate logistic regression analysis was performed on demographic, biometry, and medical/ocular history data.

Main Results:

• Significant risk factors for LIOLD included YAG capsulotomy (OR 17.17), pseudoexfoliation (OR 15.63), complicated cataract surgery (OR 17.60), and previous PPV (OR 4.86).
• Younger age at cataract surgery (OR 0.94 per year) and axial myopia (OR 1.16) were also identified as risk factors.
• Female sex was associated with a reduced risk (OR 0.64), while patients under 60 years had an increased risk, particularly those under 40 or 30.

Conclusions:

• This multinational study highlights key risk factors for LIOLD, including specific pre-existing conditions and surgical history.
• The findings underscore the importance of considering patient age and specific ocular conditions when assessing LIOLD risk.
• Further research into preventative strategies for at-risk individuals and comparative studies of IOL fixation techniques are warranted.