Surgical management of dislocated intraocular lenses

Intraocular lens (IOL) malpositions range from simple IOL decentration to luxation into the posterior segment. Many surgical techniques and approaches have been devised to treat visually significant IOL dislocation. In this series, 78 eyes with IOL dislocation were managed by anterior segment and vitreous surgeons with a variety of surgical techniques using a limbal, pars plana, or combined limbal-pars plana approach. Most of the dislocated lenses were posterior chamber IOLs. In 39 of 78 eyes (50%), final visual acuity was 20/50 or better. Neither surgical approach nor management technique appeared to be related to outcome. The timing of surgery did not appear to affect visual outcome but was not examined in a randomized fashion. Guidelines for determining optimal management are presented.