Out-Of-The-Bag Intraocular Lens Dislocation in Dead Bag Syndrome and Its Association With Eye Rubbing

Area of Science:

• Ophthalmology
• Ophthalmic Surgery
• Biomedical Science

Background:

• Dead bag syndrome (DBS) can lead to out-of-the-bag (OTB) intraocular lens (IOL) dislocation.
• Understanding the risk factors and outcomes of OTB IOL dislocation in DBS is crucial for patient management.

Purpose of the Study:

• To describe the clinical features, risk factors, and outcomes of OTB IOL dislocation in patients with DBS.
• To identify potential preventative measures for OTB IOL dislocation in DBS.

Main Methods:

• Retrospective review of a single-surgeon series of eyes with OTB IOL dislocation managed at Singapore National Eye Centre (2014-2021).
• Exclusion of eyes with secondary IOL implantation or intraoperative capsule complications.
• Collection of data on patient demographics, ocular history, clinical findings, ocular trauma (specifically eye rubbing), surgical procedures, and postoperative outcomes.

Main Results:

• Eye rubbing was the predominant form of ocular trauma (68.0%) associated with OTB IOL dislocation.
• Eye rubbers showed significantly higher rates of elevated intraocular pressure (IOP), larger posterior capsule defects, vitreous in the anterior chamber, and lower endothelial cell counts.
• Common post-IOL exchange complications included elevated IOP (22.0%), glaucoma (16.0%), and recurrent IOL subluxation (14.0%).

Conclusions:

• Eye rubbing is a significant factor in the development of OTB IOL dislocations in DBS.
• OTB IOL dislocation associated with eye rubbing presents with more severe clinical manifestations.
• Addressing the underlying cause and advising patients to minimize eye rubbing may reduce the incidence of this complication.