Epidemiology,Etiology,and Prevention of Late IOL-Capsular Bag Complex Dislocation: Review of the Literature

Posterior chamber intraocular lens (pc-iol) subluxation is uncommon but represents one of the most serious complications following phacoemulsification. late spontaneous iol-capsular bag complex dislocation is defined as occurring three months or later following cataract surgery. unlike early iol dislocation,late spontaneous iol dislocation is due to a progressive zonular dehiscence and contraction of the capsular bag many years what seemed to be uneventful surgery. in recent years,late in-the-bag iol subluxation or dislocation has been reported with increasing frequency,having a cumulative risk of iol dislocation following cataract extraction of 0.1% after 10 years and 1.7% after 25 years. a predisposition to zonular insufficiency and capsular contraction is identified in 90% of reviewed cases. multiple conditions likely play a role in contributing to this zonular weakness and capsular contraction. pseudoexfoliation is the most common risk factor,accounting for more than 50% of cases. other associated conditions predisposing to zonular dehiscence are aging,high myopia,uveitis,trauma,previous vitreoretinal surgery,retinitis pigmentosa,diabetes mellitus,atopic dermatitis,previous acute angle-closure glaucoma attack,and connective tissue disorders. the recognition of these predisposing factors suggests a modified approach in cases at risk. we review certain measures to prevent iol-bag complex luxation that have been proposed. © 2015 francisco j. ascaso et al.