In-the-bag intraocular lens dislocation.

PURPOSE: To describe the presenting characteristics and management alternatives of posterior chamber intraocular lens (PC-IOL) dislocation secondary to dehiscence of the zonules supporting the capsular bag.

DESIGN: Observational case series.

METHODS: Multicenter retrospective analysis of the surgical treatment and predisposing factors associated with 25 eyes of 22 patients with dislocation of the PC-IOL encased within the capsular bag secondary to dehiscence of the zonules supporting the capsular bag.

RESULTS: The dislocated in-the-bag PC-IOL was replaced with an anterior chamber intraocular lens in 60% or repositioned/exchanged and scleral fixated in 40% of eyes. Associated conditions included pseudoexfoliation syndrome 44%, uveitis 16%, and trauma 16%. There was no identifiable cause in 24% of eyes.

CONCLUSIONS: In-the-bag PC-IOL dislocations are an unusual, sometimes bilateral, late complication of cataract surgery that can be managed by exchange with an anterior chamber intraocular lens or by PC-IOL repositioning or replacement with scleral fixation. The most common associated condition was pseudoexfoliation.