Patients with pseudoexfoliation syndrome at risk for late PC IOL dislocation

Patients with pseudoexfoliation syndrome (PXF) may be at risk for spontaneous dislocation of posterior chamber (PC) IOLs in the capsular bag that occurs years after the cataract procedure, said Nick Mamalis, MD, professor of ophthalmology, Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City.

In a retrospective study of 57 cases of PC IOL dislocation in the capsular bag, 29 patients had PXF, 10 had retinal detachment, and some had undergone pars plana vitrectomy. The IOL dislocation occurred at a mean time of 9 years after implantation (range, 8 to 264 months).

The most common lenses that dislocated were the one-piece, plate haptic silicone lens (14 cases); the one-piece polymethylmethacrylate lens (13 cases); the 3-piece silicone lens (seven cases); and the one-piece hydrophilic lens (seven cases). This problem occurred in all types of lenses, Dr. Mamalis said.

"Patients with PXF are predisposed to this complication and surgeons need to consider ways to prevent this occurrence in these patients, such as the use of capsular tension rings," he said.

PXF syndrome was confirmed with histopathologic analysis, Dr. Mamalis said.