Characteristics of Patients with Late-onset Intraocular Lens Dislocation: A Prospective Multicenter Clinical Cohort Study in Japan.

PURPOSE

To evaluate the patients' characteristics and ocular features of those who underwent surgery for late-onset intraocular lens (IOL) dislocation from 2020 to 2021 at multiple surgical centers in Japan. We also assessed the factors influencing the duration between prior IOL implantation and IOL dislocation repair as well as the factors affecting visual prognosis after IOL dislocation repair surgery.

DESIGN

A prospective multicenter clinical cohort study.

PARTICIPANTS

The study included 712 eyes of 712 patients.

METHODS

We collected data on the patients' characteristics and ocular features and performed multivariable linear regression analyses.

MAIN OUTCOME MEASURES

Factors influencing the duration between prior IOL implantation and IOL dislocation repair, as well as factors affecting visual prognosis after repair surgery.

RESULTS

The average duration between prior IOL implantation and IOL dislocation repair surgery was 131.5 ± 85.7 months (approximately 11 years). The average age of the patients at IOL dislocation repair surgery was 67.2 ± 14.2 years. Male patients (n = 529, 74.3%) were significantly younger than female patients (P = <.0001). During IOL dislocation repair surgery, the dislocated IOL was extracted in 655 (92.0%) eyes, and a secondary IOL was implanted in 555 (77.9%) eyes using the IOL haptics scleral fixation technique. Multivariable linear regression analysis demonstrated that younger age at IOL dislocation repair surgery (P = .0008), shorter axial length (P = .0004), and use of a capsular tension ring during prior IOL implantation (P = .0004) were significantly associated with shorter duration until IOL dislocation repair surgery. Furthermore, older age at repair surgery (P = .0051), worse preoperative visual acuity (P = <.0001), being female (P = .0005), and history of vitrectomy (P = .0061) were significantly associated with worse postoperative visual acuity. IOL dislocation status did not affect visual prognosis after repair surgery.

CONCLUSIONS

This study highlights significant factors that affect the duration until late-onset IOL dislocation repair surgery and postoperative visual acuity after repair surgery. While an optimal timing for IOL dislocation repair surgery has not been fully established, our study suggests that IOL dislocation status does not affect visual prognosis.