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Abstract #18414 Published in IGR 3-3
Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients
Jehan FS; Mamalis N; Crandall ASOphthalmology 2001; 108: 1727-1731
PURPOSE: To identify a delayed complication of cataract surgery in patients with zonular weakness caused by pseudoexfoliation (PEX) syndrome. DESIGN: Retrospective, observational case series. PARTICIPANTS: Eight eyes of seven patients with clinically diagnosed PEX syndrome who had undergone previous uncomplicated cataract extraction and placement of a posterior chamber intraocular lens (IOLs). METHODS: This study evaluated eight cases of late spontaneous dislocation of posterior chamber IOLs within the capsular bag in patients with PEX syndrome. Data were gathered retrospectively from patients' operative reports, medical records, and pathology reports. MAIN OUTCOME MEASURES: Interval between original surgery and dislocation; final best-corrected visual acuity and ocular outcome. RESULTS: All patients had a diagnosis of PEX syndrome and had previously undergone uncomplicated cataract surgery. No patient had any other predisposing factors that would lead to zonular dehiscence or weakness. Delayed dislocation of the entire capsular bag containing the IOL occurred spontaneously in all cases. Mean time from IOL implantation to dislocation was approximately 85 months (seven years and one month; range, 57-115 months) after surgery. Seven eyes were successfully treated with IOL exchange: six with placement of an anterior chamber IOL and one with scleral fixation of a posterior chamber IOL. The remaining case was treated by scleral fixation of the dislocated IOL. Gross pathology analysis of seven cases confirmed the presence of the IOL within the intact capsular bag. Six eyes achieved a final best-corrected visual acuity of 20/40 or better. CONCLUSIONS: Patients with PEX syndrome may be at risk for delayed spontaneous dislocation of their IOL within the capsular bag after uncomplicated cataract surgery. Awareness of this newly recognized long-term complication may justify a re-evaluation of surgical considerations for cataract removal in these patients.
Dr N. Mamalis, 50 North Medical Drive, Salt Lake City, UT 84132, USA
Classification:
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
