Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature

Posterior chamber intraocular lens (PC-IOL) subluxation is uncommon but represents one of the most serious complications following phacoemulsification. Late spontaneous IOL-capsular bag complex dislocation is defined as occurring three months or later following cataract surgery. Unlike early IOL dis...

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Main Authors: Francisco J. Ascaso, Valentín Huerva, Andrzej Grzybowski
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2015/805706
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author Francisco J. Ascaso
Valentín Huerva
Andrzej Grzybowski
author_facet Francisco J. Ascaso
Valentín Huerva
Andrzej Grzybowski
author_sort Francisco J. Ascaso
collection DOAJ
description Posterior chamber intraocular lens (PC-IOL) subluxation is uncommon but represents one of the most serious complications following phacoemulsification. Late spontaneous IOL-capsular bag complex dislocation is defined as occurring three months or later following cataract surgery. Unlike early IOL dislocation, late spontaneous IOL dislocation is due to a progressive zonular dehiscence and contraction of the capsular bag many years what seemed to be uneventful surgery. In recent years, late in-the-bag IOL subluxation or dislocation has been reported with increasing frequency, having a cumulative risk of IOL dislocation following cataract extraction of 0.1% after 10 years and 1.7% after 25 years. A predisposition to zonular insufficiency and capsular contraction is identified in 90% of reviewed cases. Multiple conditions likely play a role in contributing to this zonular weakness and capsular contraction. Pseudoexfoliation is the most common risk factor, accounting for more than 50% of cases. Other associated conditions predisposing to zonular dehiscence are aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders. The recognition of these predisposing factors suggests a modified approach in cases at risk. We review certain measures to prevent IOL-bag complex luxation that have been proposed.
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spelling doaj-art-db0a5c7263b04d8f8f757572ff65c4e02025-08-20T03:24:26ZengWileyJournal of Ophthalmology2090-004X2090-00582015-01-01201510.1155/2015/805706805706Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the LiteratureFrancisco J. Ascaso0Valentín Huerva1Andrzej Grzybowski2Department of Ophthalmology, University Clinic Hospital Lozano Blesa, Avenida San Juan Bosco 15, 50009 Zaragoza, SpainDepartment of Ophthalmology, University Hospital Arnau de Vilanova, Avenida Rovira Roure 80, 25198 Lleida, SpainDepartment of Ophthalmology, Poznan City Hospital, Ulica Szwajcarska 3, 61-285 Poznan, PolandPosterior chamber intraocular lens (PC-IOL) subluxation is uncommon but represents one of the most serious complications following phacoemulsification. Late spontaneous IOL-capsular bag complex dislocation is defined as occurring three months or later following cataract surgery. Unlike early IOL dislocation, late spontaneous IOL dislocation is due to a progressive zonular dehiscence and contraction of the capsular bag many years what seemed to be uneventful surgery. In recent years, late in-the-bag IOL subluxation or dislocation has been reported with increasing frequency, having a cumulative risk of IOL dislocation following cataract extraction of 0.1% after 10 years and 1.7% after 25 years. A predisposition to zonular insufficiency and capsular contraction is identified in 90% of reviewed cases. Multiple conditions likely play a role in contributing to this zonular weakness and capsular contraction. Pseudoexfoliation is the most common risk factor, accounting for more than 50% of cases. Other associated conditions predisposing to zonular dehiscence are aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders. The recognition of these predisposing factors suggests a modified approach in cases at risk. We review certain measures to prevent IOL-bag complex luxation that have been proposed.http://dx.doi.org/10.1155/2015/805706
spellingShingle Francisco J. Ascaso
Valentín Huerva
Andrzej Grzybowski
Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature
Journal of Ophthalmology
title Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature
title_full Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature
title_fullStr Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature
title_full_unstemmed Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature
title_short Epidemiology, Etiology, and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature
title_sort epidemiology etiology and prevention of late iol capsular bag complex dislocation review of the literature
url http://dx.doi.org/10.1155/2015/805706
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AT valentinhuerva epidemiologyetiologyandpreventionoflateiolcapsularbagcomplexdislocationreviewoftheliterature
AT andrzejgrzybowski epidemiologyetiologyandpreventionoflateiolcapsularbagcomplexdislocationreviewoftheliterature