Long-term results of late “in-the-bag” IOL dislocation surgery

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BACKGROUND: Intraocular lens (IOL) repositioning and IOL exchange are the main methods of surgical treatment of late “in-the-bag” IOL dislocation.

AIM: To evaluate refraction, induced corneal astigmatism and IOL tilt after surgical treatment of late “in-the-bag” IOL dislocation by transscleral suture fixation and exchange to “iris-claw” IOL with retropupillary fixation.

MATERIALS AND METHODS: 78 of patients with late “in-the-bag” IOL dislocation were included. Transscleral suture IOL fixation was performed in group I (38 eyes), exchange to “iris-claw” IOL was performed in group II (40 eyes). Refractometry, keratotopography and optical coherence tomography of anterior segment were performed before surgery, 1 week, 1, 3 and 6 months after surgery.

RESULTS: The groups did not differ in subjective and objective refraction. But there was significant variability of data in the group I 3 and 6 months after surgery. There was no difference in corneal astigmatism in both groups during 3 months, but a significant increase was found in group II 6 months after surgery. There was no difference in IOL tilt between groups before surgery. Decrease of IOL tilt in 180 degrees plane was observed after 1 month in group II, while there was no difference in 90 degrees plane between groups.

CONCLUSIONS: Both methods of late “in-the-bag” IOL dislocation treatment allow to receive good refractive result, but refraction is less predictable after trans-scleral suture IOL fixation. Surgically induced astigmatism is higher in IOL exchange group due to large sclerocorneal tunnel incision. Transscleral suture IOL fixation does not cause clinically significant IOL tilt.

作者简介

Vitaliy Potemkin

Academician I.P. Pavlov First St. Petersburg State Medical University; City Multidisciplinary Hospital No. 2, Saint Petersburg

Email: potem@inbox.ru
ORCID iD: 0000-0001-7807-9036
SPIN 代码: 3132-9163

Cand. Sci. (Med.), assistant professor of Department of Ophthalmology with Clinic; head of 5th Microsurgical Ophthalmology Department

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Sergey Astakhov

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: astakhov73@mail.ru
ORCID iD: 0000-0003-0777-4861
SPIN 代码: 7732-1150
Scopus 作者 ID: 56660518500

MD, Dr. Sci. (Med.), professor, head of Department of Ophthalmology with Clinic

俄罗斯联邦, Saint Petersburg

Tat’yana Varganova

City Multidisciplinary Hospital No. 2, Saint Petersburg

Email: varganova.ts@yandex.ru

MD, Cand. Sci. (Med.), ophthalmologist

俄罗斯联邦, Saint Petersburg

Xiaoyuan Wang

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: wangxiaoyuan20121017@gmail.com
ORCID iD: 0000-0002-1135-6796

postgraduate student of Department of Ophthalmology with Clinic

俄罗斯联邦, Saint Petersburg

Liliia Anikina

Academician I.P. Pavlov First St. Petersburg State Medical University; City Multidisciplinary Hospital No. 2, Saint Petersburg

编辑信件的主要联系方式.
Email: lily-sai@yandex.ru
ORCID iD: 0000-0001-8794-0457
SPIN 代码: 3359-4587

postgraduate student, ophthalmologist

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Shohida Babaeva

North-Western State Medical University named after I.I. Mechnikov

Email: babaevasho@gmail.com
ORCID iD: 0000-0003-1047-9230

student of Department of general medicine

俄罗斯联邦, Saint Petersburg

参考

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2. Fig. 1. Tomey SS-1000 CASIA keratotopography protocol

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3. Fig. 2. Base line and Intraocular lens line determination

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4. Fig. 3. Intraocular lens tilt determination

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5. Fig. 4. Changes in corneal astigmatism

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6. Fig. 5. Changes in Intraocular lens tilt: a — in 180 degrees meridian; b — in 90 degrees meridian

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