Dataset Information

Incidence and Characteristics of Intraocular Lens Dislocation after Phacoemulsification: An Eight-Year, Nationwide, Population-Based Study.

ABSTRACT:

Background

We investigate the incidence and characteristics of IOL dislocation among the pseudophakic population after phacoemulsification.

Methods

National data were collected from the health claims recorded with the Health Insurance Review and Assessment Service of South Korea from 2009 to 2016. Pseudophakic patients aged 40 years or older were included. The incidence estimates of phacoemulsification and IOL dislocation were analyzed, and the cumulative probabilities of IOL dislocation among the pseudophakic population and general population were calculated as a proportion.

Results

Of 51,307,821 total subjects, 25,271,917 of whom were aged 40 years or older, 3,906,071 cataract cases in 2,650,104 pseudophakic patients were identified, and 72,309 patients experienced IOL dislocation. The cumulative probability was 2.73% per person and 1.85% per surgery among patients 40 years of age or older. The eight-year incidence rate for IOL dislocation in the pseudophakic population aged 40 years or older was 7671 per 1,000,000 person-years (95% CI: 7616-7727), including 10,341 cases in men and 5814 in women. Incidence peaked in the seventh decade of life for cataract surgery but in the fifth decade of life for IOL dislocation. The cumulative probability of IOL dislocation after phacoemulsification was approximately 2%, and the incidence rate was about 7000 per 1,000,000 pseudophakic patients.

Conclusions

There was a significantly higher incidence of IOL dislocation among young males, even though the higher incidence of cataract surgery was observed among older females. These estimates of the nationwide, population-based incidence of IOL dislocation can help increase understanding of the population vulnerable to IOL dislocation.

SUBMITTER: Lee GI

PROVIDER: S-EPMC8432084 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PURPOSE:To compare the efficacy and safety of intraocular lens (IOL) repositioning and IOL exchange for the treatment of patients with IOL dislocation. METHODS:We systematically searched for relevant publications in English or Chinese in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, WHO International Clinical Trial Registration Platform, Clinical Trial.gov, China Biology Medicine Database, China National Knowledge Infrastructure Database and grey literature sources. Study quality was assessed using the STROBE template for observational studies and the Cochrane template for randomized controlled trials (RCTs). Data were meta-analyzed using RevMan 5.3. RESULTS:The review included 14 English-language studies reporting 1 RCT and 13 retrospective case series involving 1,082 eyes. Average follow-up time was 13.7 months. Pooled analysis of 10 studies showed that the two procedures had a similarly effect on best corrected visual acuity (MD -0.00, 95%CI: -0.08 to 0.08, P = 0.99). Pooled analysis of nine studies showed no significant difference in incidence of IOL redislocation (RR 2.12, 95%CI 0.85 to 5.30, P = 0.11); pooled analysis of seven studies showed greater extent of incidence of cystoid macular edema in IOL exchange (RR 0.47, 95%CI 0.21 to 1.30, P = 0.06). Pooled analysis of three studies showed greater extent of incidence of anterior vitrectomy in IOL exchange (RR 0.11, 95%CI 0.04 to 0.33, P<0.0001). Pooled analysis of two studies showed greater postoperative spherical equivalents in IOL repositioning (MD 1.02, 95%CI 0.51 to 1.52, P<0.0001). pooled analysis suggested no significant differences between the two procedures in terms of intraocular pressure, endothelial cell density, surgically induced astigmatism, or incidence of retinal detachment, intraocular hemorrhage or pupillary block. CONCLUSION:IOL repositioning and exchange are safe and effective procedures for treating IOL dislocation. Neither procedure significantly affects best corrected visual acuity and IOL redislocation. IOL exchange was superior to repositioning in terms of postoperative SE, but IOL repositioning was associated with lower incidence of anterior vitrectomy, potentially lower incidence of cystoid macular edema.