Risk factors and complications arising in case of late spontaneous dislocations of the complex «posterior chamber IOL - capsular bag» into the vitreous body

Purpose. To identify the main risk factors and concomitant complications of late spontaneous dislocations of the complex ...x|á|/x|posterior chamber IOL - capsular bag...x|â|/x| into the vitreous body. Material and methods. The study performed an analysis of 223 case histories of patients with late dislocations of posterior chamber IOL within the period 2013-2015. We took into account the gender composition, age of the patients, method of cataract removal, specifications of luxated IOL. Visual acuity, intraocular pressure level and refraction at the moment of the patient's visit with the IOL dislocation, concomitant ophthalmic pathology were evaluated. Results. In 2013-2015 surgical interventions for cataract and its complications in case of late IOL dislocations were carried out in 1.15% of cases. Pseudoexfoliation syndrome was initially diagnosed in 85.2% of patients. The average period from the moment of IOL implantationuntil its spontaneous luxation into vitreous body was 8.78...4.85 years. Uncorrected visual acuity (UCVA) during the visit concerning the IOL luxation was reduced up to 0.15...0.16. Best corrected visual acuity (BCVA) to 0.32...0.25 was with a shift of the spherical component in the direction of hyperopia up to 2.04...4.81 diopters, cylindrical component did not exceed -0.40...0.78 diopters. In 59.2% of cases the IOL luxation was accompanied by hydrodynamic disturbances. Therewith, the IOP was compensated with medication in 81.07% cases, antiglaucomatous interventions were carried out previously in 11.36% of cases, the reposition or replacement of the luxated IOL was accompanied by an antiglaucomatous component in 7.57%. Conclusions. The main risk factor for the dislocation of the complex ...x|á|/x|posterior chamber IOL - capsular bag...x|â|/x| is pseudoexfoliation syndrome causing a weakness and a progredient destruction of the zonular system of the lens. Moreover, the risk factors of late IOL dislocation are axial myopia, vitreoretinal surgery and glaucoma in anamnesis. The main complication of late IOL dislocation is a development and progression of hydrodynamic disorders, revealed in 59.2% of patients. Patients with pseudoexfoliation syndrome, operated for cataract, are subjects to a risk of a late IOL dislocation in the capsular bag in the long-term postoperative period, regardless of the IOL type.