Marius Dalby1, Liv Drolsum, Olav Kristianslund. 1. 1Department of Ophthalmology, Oslo University Hospital, Oslo, Norway 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Abstract
PURPOSE: To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. SETTING: Patients referred to Oslo University Hospital. DESIGN: Prospective cohort study. METHODS: The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by one surgeon. The following IOL designs were repositioned; 1-piece foldable (n=17), 3-piece foldable (n=28), plate haptic (n=8), and 1-piece rigid (n=1). Patients were evaluated comprehensively before surgery, and 6 months (80%), 1 year (67%), and 2 years (61%) after surgery. The main outcome measures were efficacy in terms of corrected distance visual acuity (CDVA) and spherical equivalent (SE), and safety in terms of complications. RESULTS: Postoperative visual acuity was similar for different IOL designs. Mean SE change to final observation was -0.08 (95% CI, -0.93, 0.77) in the 1-piece group, and -0.98 (-1.73, -0.23) in the 3-piece group (P = .11). In terms of safety, no patients had uveitis-glaucoma-hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. CONCLUSIONS: Repositioning surgery of 1-piece IOLs appears as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation.
PURPOSE: To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. SETTING:Patients referred to Oslo University Hospital. DESIGN: Prospective cohort study. METHODS: The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by one surgeon. The following IOL designs were repositioned; 1-piece foldable (n=17), 3-piece foldable (n=28), plate haptic (n=8), and 1-piece rigid (n=1). Patients were evaluated comprehensively before surgery, and 6 months (80%), 1 year (67%), and 2 years (61%) after surgery. The main outcome measures were efficacy in terms of corrected distance visual acuity (CDVA) and spherical equivalent (SE), and safety in terms of complications. RESULTS: Postoperative visual acuity was similar for different IOL designs. Mean SE change to final observation was -0.08 (95% CI, -0.93, 0.77) in the 1-piece group, and -0.98 (-1.73, -0.23) in the 3-piece group (P = .11). In terms of safety, no patients had uveitis-glaucoma-hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. CONCLUSIONS: Repositioning surgery of 1-piece IOLs appears as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation.