How common is lens dislocation after cataract surgery?

A dislocated intraocular lens (IOL) after cataract surgery is rare and occurs in less than 3% of cases, but it can be a serious complication that may require surgery to repair.

Sufferers usually have the following disorders or previous procedures:

• Crystalline pseudoexfoliation syndrome (PSX), which consists of breakage of the fibers of the ligaments that support the natural lens of the eye (zonule).
• High myopia
• Previously performed surgical procedures, such as glaucoma and vitrectomy
• Eye injuries

Categories of IOL Dislocation

There are two categories of a shifted or dislocated IOL. The first happens soon after cataract surgery and is caused by a break in the support which holds the lens capsule in place. The second category of lens dislocation happens gradually over time as the support weakens and causes the lens to shift away from the center of the pupil. This happens more often in patients with a history of eye trauma, multiple eye surgeries, especially retinal detachment repair, and complicated original cataract surgery.

Symptoms Dislocated Intraocular Lens

The most common symptom is a change in vision. The change in vision depends on how severe the dislocation is. Vision in the eye with a dislocated IOL tends to be very blurry. However, if the lens is only slightly out of position, then there may be a ghost image or double image at night when light passes through the pupil around the edge of the lens.

How can it be prevented?

IOL dislocation cannot be prevented as it occurs spontaneously. It is important, however, for patients who have undergone cataract surgery to have regular check-ups and urgently visit the ophthalmologist if they notice any loss of vision.

Treatments for Dislocated Intraocular Lens

Treatment depends on the severity of the dislocation. Some dislocations are minor and visual acuity is still good. In these cases, only observation is necessary until the lens further dislocates. If the lens has dislocated enough to cause blurry vision surgery is necessary. Sometimes the original lens can just be repositioned and in other cases it requires a new lens that is designed to be sutured to the wall of the eye or to the iris. Sometimes a lens has fallen into the vitreous cavity and a vitrectomy is required. A vitrectomy is the removal of the vitreous jelly inside the eye so the displaced lens can be removed. This surgery is done by a retinal specialist.   

Outcome and Follow-Up

As with all surgeries there is the possibility of complications, but most patients with IOL repositioning or IOL replacement do quite well. Each patient is different and your surgeon will discuss your individual case and possible outcome with you before your surgery. Should you be concerned that you or a loved one is experiencing complications such as a dislocated Intraocular Lens please contact your provider as soon as possible.