Repositioning surgery of different intraocular lens designs in eyes with late in-the-bag intraocular lens dislocation

Purpose To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. Setting Patients referred to Oslo University Hospital. Design Prospective cohort study. Methods The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by one surgeon. The following IOL designs were repositioned; 1-piece foldable (n=17), 3-piece foldable (n=28), plate haptic (n=8), and 1-piece rigid (n=1). Patients were evaluated comprehensively before surgery, and 6 months (80%), 1 year (67%), and 2 years (61%) after surgery. The main outcome measures were efficacy in terms of corrected distance visual acuity (CDVA) and spherical equivalent (SE), and safety in terms of complications. Results Postoperative visual acuity was similar for different IOL designs. Mean SE change to final observation was -0.08 (95% CI, -0.93, 0.77) in the 1-piece group, and -0.98 (-1.73, -0.23) in the 3-piece group (P = .11). In terms of safety, no patients had uveitis-glaucoma-hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. Conclusions Repositioning surgery of 1-piece IOLs appears as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation.