Intraocular lens dislocation

摘要

Cataract surgery with intraocular lens (IOL) implantation has evolved into highly successful surgery. However, IOL dislocations are among the most common complications following this surgery. The yearly ASCRS-ESCRS survey of foldable IOLs requiring explantation or secondary intervention analyzed at the University of Utah's Intermountain Ocular Research Center has shown that dislocation/ decentration was overall the most common reason for IOL explantation over the past decade.It is interesting to note that IOL dislocation seems to occur in a bimodal distribution. Early IOL dislocation is usually secondary to improper fixation of the IOL within the capsular bag, issues with asymmetric IOL fixation, or an incomplete or torn capsulorhexis. Overall, the incidence of early IOL dislocation has decreased with the increased use of a continuous curvilinear capsulorhexis and improved phacoemul-sification techniques, which allow complete removal of a cataract with secure placement of the IOL within the capsular bag. Late IOL dislocation is often associated with spontaneous IOL dislocation within the intact capsular bag, and the incidence of this complication has increased recently. These late dislocations are generally associated with conditions of zonular weakness rather than inadequate IOL fixation.