Kristianslund Olav, Dalby Marius, Drolsum Liv
From the Department of Ophthalmology, Oslo University Hospital, Oslo Norway (Kristianslund, Dalby, Drolsum); Institute of Clinical Medicine, University of Oslo, Oslo, Norway (Kristianslund, Dalby, Drolsum).
J Cataract Refract Surg. 2021 Jul 1;47(7):942-954. doi: 10.1097/j.jcrs.0000000000000605.
This review aimed to evaluate the cumulative incidence, patient characteristics, predisposing conditions, and treatment outcomes for late in-the-bag intraocular lens (IOL) dislocation. Literature searches in PubMed (MEDLINE), Embase, and Cochrane Library Central database identified 1 randomized clinical trial, 1 prospective case series, 2 prospective cohort studies, and 36 retrospective studies of this condition, which showed that the cumulative incidence was 0.5% to 3%, it occurred on average 6 to 12 years after cataract surgery, and mean patient age was 65 to 85 years. Pseudoexfoliation syndrome, myopia, and previous vitreoretinal surgery were the most common predisposing conditions. Studies indicated that IOL repositioning and IOL exchange provided similar visual outcomes and were equally safe. The long-term visual outcome seemed satisfactory. However, the quality of evidence regarding treatment was in general quite low. More studies of late in-the-bag IOL dislocation are needed, and in particular, different surgical techniques should be included in high-quality clinical trials.
本综述旨在评估后房型人工晶状体（IOL）迟发性脱位的累积发病率、患者特征、诱发因素及治疗效果。在PubMed（MEDLINE）、Embase和Cochrane图书馆中央数据库中进行文献检索，确定了1项随机临床试验、1项前瞻性病例系列研究、2项前瞻性队列研究以及36项关于该病症的回顾性研究，这些研究表明累积发病率为0.5%至3%，平均发生于白内障手术后6至12年，患者平均年龄为65至85岁。假性剥脱综合征、近视和既往玻璃体视网膜手术是最常见的诱发因素。研究表明，人工晶状体复位和人工晶状体置换提供了相似的视觉效果，且安全性相当。长期视觉效果似乎令人满意。然而，关于治疗的证据质量总体较低。需要更多关于后房型人工晶状体迟发性脱位的研究，特别是高质量临床试验应纳入不同的手术技术。
