Surgery for late in-the-bag IOL dislocation yields long-term vision improvements

Surgical management of late in-the-bag subluxated intraocular lenses (IOLs) yields improvements in visual function, a recent study has shown.

The researchers conducted a single-centre prospective study of 165 patients (mean age, 79.2±8.9 years; 57 percent female) who had had surgical correction for late in-the-bag dislocation of the IOL. Patients were followed up at 1 year, during which the primary outcomes of best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were assessed.

A new composite factor, IOP issue, was created and composed of: previous glaucoma surgery, ongoing pressure-reducing medication, and an IOP of ≥23 mmHg before operation. IOP issue was also set as a primary outcome.

At baseline, mean BCVA was 0.64±0.48 logMAR. A year after the procedure, this statistically improved to 0.32±0.41 logMAR (p<0.001). BCVA at follow-up was also comparable between patients who had undergone IOL reposition or exchange. Notably, those who had logMAR vision worse than 0.3 at baseline (p=0.001), or those who were ≥85 years of age (p=0.003) were at risk of poorer final BCVA.

Similarly, mean IOP dropped significantly from 20.1±8.4 mm Hg at baseline to 18.4±6.0 mm Hg at follow-up (p=0.02). Findings were again comparable between those who underwent IOL exchange vs repositioning.

On the other hand, IOP issue did not seem to change. At baseline, 47.3 percent had a pressure issue, and the same percentage of participants reported so at follow-up. Most of those who were affected at baseline still had an IOP issue a year after the procedure. Multivariate analysis found that having a pressure issue at baseline was a significant risk factor for such an issue at follow-up (p<0.001).