IOL Dislocation Found to Be More Common in High Myopes, Hypertensives and Smokers

Intraocular lens (IOL) implantation is standard of care for restoring the sight of cataract patients following phacoemulsification, with very high success rates. However, it is possible for complications to arise with these lenses, such as lens dislocation. Although this is not a common issue (reportedly happening in anywhere from 0.1% to 3.0% of cases), it is a notable risk factor. Interventions include explanting the lens, moving it back into place or exchanging it for a different type; however, there is a limited amount of published literature examining patients who have been reevaluated for their disrupted lens. This image from the study shows several forms of IOL dislocation that manifested among subjects. Such patients may be treated by repositioning, exchanging or explanting the lens to improve the patient’s visual acuity. Photo: Xu S, et al. PLoS One. June 25, 2025. Click image to enlarge. In a recent study, researchers from China analyzed data on 155 patients (166 eyes) from 2016 to 2024 on patients with IOL dislocation if they had complete clinical and follow-up data and if they could cooperate to complete ocular examinations. This study reported on demographics, comorbidities, personal history of unhealthy habits, IOL dislocation characteristics and surgical treatment outcomes. Here are the results: Of the 155 patients, 73.5% were male. The median age of the study’s population was 55. Men with IOL dislocation were at their peak onset age between 49 and 59 years; for women it was between ages 59 and 69. Most patients  (58.1%) resided in urban areas. Significantly present systemic comorbidities included hypertension (28.4%) and diabetes (10.3%) while ocular comorbidities included high myopia (38.6%) and a history of vitrectomy (17.5%).Unhealthy lifestyle habits were reported by 26.5%. Smoking cigarettes accounted for 21.3% and heavy consumption of alcohol accounted for the remaining 5.2%.Of the 166 eyes that experienced IOL dislocation, 86.8% were unilaterally dislocated while the remainder were bilaterally dislocated. Recurrent dislocation was reported in 9% of eyes. Disturbances occurred for patients as early as one day postoperatively up to about 20 years. Most of these cases (89.7%) presented after three months postoperatively. Due to low endothelial cell count, 12 eyes did not undergo a lens exchange or repositioning of their lens. The 154 eyes that did receive surgery experienced significant improvements to their uncorrected distance visual acuity. One concern was the rise of intraocular pressure (IOP). Elevations were observed in 10 eyes that had their lens repositioned and eight eyes that had their lens exchanged. IOP was managed with either anterior chamber paracentesis or medication, and pressure values returned to normal within three days.“The most common postoperative complication was transient IOP elevation,” likely related to residual viscoelastic substances, but it was easily managed and imposed no long-term consequences. “Notably, no cases of serious complications such as retinal detachment were observed, indicating a relatively high level of surgical safety.”The researchers cited some limitations to their study that may have skewed their results relative to other patient populations. For instance, the Chinese study population used may have been less susceptible to pseudoexfoliation syndrome associated with IOL dislocation than Western populations. Furthermore, they believe that some selection bias and incomplete information existed in this study due to its design. They suggest that future researchers include larger populations and multiple data centers, employ imaging techniques and analyze data from a molecular biology standpoint. This could increase the understanding of IOL dislocation while promoting the exploration of other safe and effective methods of treatment.“A thorough understanding of the clinical characteristics and risk factors associated with IOL dislocation is critical for early diagnosis and individualized intervention,” concluded the authors in  their paper. “Based on eight years of clinical data, this study provides a comprehensive summary of the clinical manifestations, risk factors and short-term postoperative outcomes of patients with IOL dislocation, offering valuable guidance for clinical practice.”Click here for the journal source. Xu S, Shao J, Zhang Y, et al. Clinical characteristics and outcomes of intraocular lens dislocation: An eight-year retrospective study. PLoS One. June 25, 2025. [Epub ahead of print].