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Purpose: To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. Setting: Patients referred to Oslo University Hospital Oslo, Norway. Design: Prospective cohort study. Methods: The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by 1 surgeon. The following IOL designs were repositioned: 1-piece foldable (n = 17), 3-piece foldable (n = 28), plate-haptic (n = 8), and 1-piece rigid (n = 1) IOLs. Patients were evaluated comprehensively preoperatively and at 6 months (80%), 1 year (67%), and 2 years (61%) postoperatively. The main outcome measures were efficacy regarding corrected distance visual acuity (CDVA) and spherical equivalent (SE) and safety regarding complications. Results: Postoperative visual acuity was similar for different IOL designs. The mean SE change to final observation was -0.08 (95% CI, -0.93 to 0.77) in the 1-piece IOL group (n = 11) and -0.98 (-1.73 to -0.23) in the 3-piece IOL group (n = 18) (P =.11). Regarding safety, no patients had uveitis-glaucoma-hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece IOL group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. Conclusions: Repositioning surgery of 1-piece IOLs seems as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation. [ABSTRACT FROM AUTHOR]

This retrospective study of repositioning surgery by scleral suturing with polypropylene 10-0 for treating late in-the-bag intraocular lens dislocation showed a low rate of suture breakage in the long-term follow-up. Purpose: To investigate the long-term risk of suture breakage after scleral fixation with a polypropylene 10-0 suture in eyes with late in-the-bag intraocular lens (IOL) dislocation. Setting: Oslo University Hospital, Oslo, Norway. Design: Retrospective case series. Methods: Patients operated with scleral suturing of late in-the-bag IOL dislocation from 2007 to 2016. 192 eyes (176 patients) operated with scleral suture (polypropylene 10-0 suture) fixation of a dislocated IOL-capsule complex were identified; 91 patients (47%) were men. Results: The mean follow-up after the operation was 6.2 (95% CI, 5.7-6.7) years, and 98 patients (56%) deceased during the study. 11 eyes (6%) (11 patients) had suture breakage that required reoperation with a mean time of 5.5 (3.4-7.6) years after IOL repositioning surgery. These patients had a mean age of 73.5 (67.9-79.2) years at the time of the operation for late in-the-bag IOL dislocation vs 81.3 (79.8-82.9) years for patients who did not experience this complication (P =.004). No cases of late endophthalmitis were registered. Conclusions: The long-term risk of suture breakage was quite low after scleral fixation of late in-the-bag IOL dislocation, particularly in the oldest patients. Hence, the polypropylene 10-0 suture seems to be a safe option for scleral fixation in this patient group. [ABSTRACT FROM AUTHOR]