Cataract surgery is just one of the most common and successful surgical procedures performed today. Over the previous decade, the danger of serious complications has diminished with breakthroughs in operation instruments and techniques. In the procedure, the cataract (cloudy lens) is removed, and also a clean intraocular (in-the-eye) lens is placed. Rarely complications include intraocular lens (IOL) dislocation, whereby the lens moves the end of place.

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Symptoms

The most usual symptom of a dislocated IOL is a change in vision. The level to i beg your pardon vision is affected will count on the severity that the dislocation.


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Figure 1. Dislocated intraocular lens in vitreous cavity. Photograph courtesy that Larry Halperin, MD


This can show up as:

BlurringDouble visionSeeing the sheet of the lens implant

IOL dislocation can additionally lead to other complications such as retinal detachment, bleeding, intraocular inflammation, macular edema, glaucoma, and also corneal edema.

Causes

During most cataract surgical treatment procedures, the IOL is inserted inside the capsular bag, a sack-like framework in the eye the previously had the cloudy lens. In some situations, this extremely thin capsular bag or the fibers that hold it in ar rupture and also the IOL assistance is compromised.

Dislocation that the IOL can happen days to years after surgery and can be a result of components during the original surgery, trauma to the eye, or diseases that impact the security of the capsular bag.


Risk factors

TraumaPrior vitreoretinal surgeryCertain connective tissue disordersInflammation in the eye (uveitis)

Diagnostic testing

Your retina specialist will carry out a detailed eye exam, including a careful examination the the peripheral retina.

The dislocated IOL is occasionally photographed to document the extent of the problem. Once a clear see of the retina can not be acquired directly, an ultrasound that the eye can be helpful.

Treatment and also prognosis

Based top top the characteristics of the IOL dislocation, there space several different approaches to repairing this issue.

In cases where the IOL dislocation is minimal and does not have a big impact ~ above vision, your doctor may not recommend any treatment in ~ all.

When vision is influenced and the patient is experiencing symptoms, surgical treatment becomes necessary. In this operation procedure, the vitreous gelatin that fills the eye’s behind cavity is eliminated (vitrectomy) to avoid pulling top top the retina if the IOL is gift manipulated.

Techniques because that repairing a dislocated IOL fall into 2 categories. Your physician will chose the one that is most suitable based on your IOL kind and the anatomy of your eye:

IOL rescue/reposition: The dislocated IOL is preserved and also repositioned in a an ext stable location. The opportunity of utilizing the currently lens is based upon many components including the style and condition the the IOL.IOL exchange: The IOL is removed and a brand-new IOL is inserted.

Potential complications of the procedure include retinal detachment, uveitis (inflammation within the eye), infection, glaucoma, bleeding, and re-dislocation the the IOL.

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With prompt and also careful management, most patients with IOL dislocation have actually a an excellent visual outcome following a corrective procedure.


Authors

thank YOU to THE RETINA HEALTH series AUTHORSSophie J. Bakri, MDAudina Berrocal, MDAntonio Capone, Jr., MDNetan Choudhry, MD, FRCS-CThomas Ciulla, MD, MBAPravin U. Dugel, MDGeoffrey G. Emerson, MD, PhDK. Bailey Freund, MDRoger A. Goldberg, MD, MBADarin R. Goldman, MDDilraj Grewal, MDLarry Halperin, MDVi S. Hau, MD, PhDSuber S. Huang, MD, MBAG. Baker Hubbard, MDMark S. Humayun, MD, PhDTalia R. Kaden, MDPeter K. Kaiser, MDM. Ali Khan, MDAnat Loewenstein, MDMathew J. MacCumber, MD, PhDMaya Maloney, MDTimothy G. Murray, MD, MBAHossein Nazari, MDOded Ohana, MD, MBAJonathan L. Prenner, MDGilad Rabina, MDCarl D. Regillo, MD, FACSNaryan Sabherwal, MDSherveen Salek, MDAndrew P. Schachat, MD

Adrienne W. Scott, MD

Michael Seider, MDJanet S. Sunness, MDEduardo Uchiyama, MDAllen Z. Verne, MDChristina Y. Weng, MD, MBAYoshihiro Yonekawa, MDEDITOR

John T. Thompson, MD

Spanish series EditorsJ. Fernando Arevalo, MD, PhDGabriela Lopezcarasa Hernandez, MDAndres Lisker, MDVirgilio Morales-Canton, MDMEDICAL ILLUSTRATOR

Tim Hengst