Occurrence of capsular delamination in the dislocated in-the-bag intraocular lens

To examine the lens capsules of dislocated in-the-bag IOLs. Retrospective case series. Nineteen dislocated IOLs encased in capsules (in-the-bag IOLs) from 19 patients were included. The clinical characteristics of the 19 patients were reviewed. The explanted in-the- bag IOLs were examined by scanning electron microscopy. Associated clinical conditions included pseudoexfoliation (PEX) in seven eyes, high myopia in three eyes, previous history of trauma in two eyes, previous vitreoretinal surgery in two eyes, retinitis pigmentosa in one eye and uveitis in one eye. PEX specimens showed capsular contraction, shrinkage of the diameter of the capsular bag and dehiscence of zonular fibers. The remaining 12 specimens exhibited slight capsular contraction that lacked shrinkage of the bag and exhibited capsular delamination at the equatorial region, in which the zonular fibers had completely disappeared. Capsular delamination as well as dehiscence of zonular fibers may be involved in the dislocation of in-the-bag IOLs.