The Clinical and Refractive Outcomes of Internal Fixation Method in Intraocular Lens Dislocation

OBJECTIVES: To reveal the clinical and refractive results of internal fixation surgery in patients who underwent intraocular lens (IOL) fixation.

METHODS: This retrospective study included 40 eyes of 40 patients (FM/M: 20/20) who have been operated for dislocated IOL in Balýkesir University, Faculty of Medicine. The demographic and clinical data were obtained from the files. The demographic data (age, sex, comorbidities, systemic treatment), the cause of IOL dislocation, primary surgery-dislocation duration, best-corrected visual acuity (BCVA) (decimals), objective refraction, spherical equivalent (SE), intraocular pressure (IOP), the status of centration, endothelial cell density (ECD), and complications were recorded. Pre-operative parameters compared with the final visit parameters as post-operative results.

RESULTS: The cause of dislocation was spontaneous in 80% of the patients, and trauma in 20%. The mean duration between cataract surgery and IOL dislocation was 33.2±39.6 months. The mean follow-up time was 19.8±8.3 months. The BCVA was improved from 0.12±0.21 to 0.73±0.33 (p=0.001), and IOP was changed from 17.6±3.2 to 17.9±2.9 mmHg (p=0.672) after surgery. The SE was decreased from 5.52±2.95 to −0.73±1.32 D (p=0.023), and the total astigmatism was decreased from 2.74±2.63 to 1.38±0.75 D (p=0.014) after surgery. ECD was increased from 1740.6±219.8 cell/mm2 to 1724.5±243.0 cell/mm2 (p=0.219). In the final visit, IOL was found centralized in 90% of patients through both miotic and mydriatic pupils. The post-operative complications were intravitreal hemorrhage in 2.5%, corneal edema in 7.5%, and ocular hypertension in 2.5%.

DISCUSSION AND CONCLUSION: Internal IOL fixation is a safe and reliable method in patients with dislocated IOLs, and it can be applied by fixating the dislocated IOL regardless of the haptic type. Post-operative results are acceptable.