Late in-the-bag intraocular lens dislocation several years after uncomplicated cataract surgery is relatively common in pseudoexfoliation

The Science behind the Tip

In pseudoexfoliation syndrome (PSX) and pseudoexfoliative glaucoma (PSG) progressive zonular damage frequently leads to in-the-bag IOL dislocation/subluxation even after seemingly uncomplicated cataract surgery. In PSX/PSG IOL dislocation typically appears several years after cataract surgery.

Therefore, eyes with late IOL dislocation are also often found to have pseudoexfoliation. Patients with pseudoexfoliation may be deemed to require regular assessment of IOL status in the long term and eyes with spontaneous late IOL dislocation need follow-up for the emergence of pseudoexfoliative glaucoma.

Contributor: Gábor Holló, Hungary

References

1. Vazquez-Ferreiro P, Carrera-Hueso FJ, Fikri-Benbrahim N, Barreiro-Rodriguez L, Diaz-Rey M, Ramón Barrios MA. Intraocular lens dislocation in pseudoexfoliation: a systematic review and meta-analysis. Acta Ophthalmol. 2017;95:e164-e169.
2. Leung VC, Singh H, Ahmed II. Inter-eye differences in patients with pseudoexfoliation syndrome presenting with intraocular lens dislocation. Ophthalmology 2015;122:480-485.
3. Mönestam E. Frequency of intraocular lens dislocation and pseudophacodonesis, 20 years after cataract surgery - a prospective study. Am J Ophthalmol 2019;198:215-222.

Tip Reviewer: Roger Hitchings
Tip Editors: Frances Meier-Gibbons, Humma Shahid, Karl Mercieca, Francisco Goni