Hayashi Ken, Sato Tatsuhiko, Gotoh Norihito, Kamiya Kazutaka, Kojima Takashi, Sato Masaki, Tabuchi Hitoshi, Hatsusaka Natsuko, Tokuda Yoshihiro
From the Hayashi Eye Hospital (K.H.), Fukuoka, Japan.
From the Hayashi Eye Hospital (K.H.), Fukuoka, Japan.
Am J Ophthalmol. 2025 Apr;272:136-144. doi: 10.1016/j.ajo.2025.01.020. Epub 2025 Jan 30.
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.
A prospective multicenter clinical cohort study.
The study included 712 eyes of 712 patients.
We collected data on the patients' characteristics and ocular features and performed multivariable linear regression analyses.
Factors influencing the duration between prior IOL implantation and IOL dislocation repair, as well as factors affecting visual prognosis after repair surgery.
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.
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.
评估2020年至2021年期间在日本多个手术中心接受迟发性人工晶状体（IOL）脱位手术患者的特征和眼部特征。我们还评估了影响先前IOL植入与IOL脱位修复之间时间间隔的因素，以及影响IOL脱位修复手术后视力预后的因素。
一项前瞻性多中心临床队列研究。
该研究纳入了712例患者的712只眼。
我们收集了患者的特征和眼部特征数据，并进行了多变量线性回归分析。
影响先前IOL植入与IOL脱位修复之间时间间隔的因素，以及影响修复手术后视力预后的因素。
先前IOL植入与IOL脱位修复手术之间的平均时间间隔为131.5±85.7个月（约11年）。IOL脱位修复手术时患者的平均年龄为67.2±14.2岁。男性患者（n = 529，74.3%）明显比女性患者年轻（P = <.0001）。在IOL脱位修复手术中，655只眼（92.0%）取出了脱位的IOL，555只眼（77.9%）使用IOL袢巩膜固定技术植入了二期IOL。多变量线性回归分析表明，IOL脱位修复手术时年龄较小（P = .0008）、眼轴长度较短（P = .0004）以及先前IOL植入时使用囊袋张力环（P = .0004）与IOL脱位修复手术前的时间间隔较短显著相关。此外，修复手术时年龄较大（P = .0051）、术前视力较差（P = <.0001）、女性（P = .0005）以及玻璃体切割术史（P = .0061）与术后视力较差显著相关。IOL脱位状态不影响修复手术后的视力预后。
本研究突出了影响迟发性IOL脱位修复手术前时间间隔和修复手术后视力的重要因素。虽然IOL脱位修复手术的最佳时机尚未完全确定，但我们的研究表明IOL脱位状态不影响视力预后。
