Eyeworld

54 | EYEWORLD | JUNE 2022 ATARACT C by Liz Hillman Editorial Co-Director About the physicians Nick Mamalis, MD Professor of Ophthalmology and Visual Sciences John A. Moran Eye Center University of Utah Salt Lake City, Utah Steven Safran, MD Lawrenceville, New Jersey L ens dislocation is a spectrum. It can be anywhere from a small amount of de- centration to a complete dislocation with the IOL-capsular bag complex sinking into the posterior chamber or falling into the vitreous. It can occur in the immediate postoperative period or "late," which is consid- ered anything after 3 months postop, according to Nick Mamalis, MD. For the most part, Dr. Mamalis said, spontaneous late IOL dislocation occurs about 10 years postop. In this article, EyeWorld looks at late dislocations that don't appear to be related to surgical complications. Late dislocations have different etiologies. Trauma can dislocate the lens-bag complex, but the physicians EyeWorld spoke to, Dr. Mamalis and Steven Safran, MD, focused on spontaneous late dislocations. Why lens-bag complexes dislocate The most common reason Dr. Mamalis and Dr. Safran cited for spontaneous lens-bag disloca- tions is pseudoexfoliation syndrome. Dr. Mama- lis said the Ophthalmic Pathology Laboratory at the John A. Moran Eye Center has conducted studies on dislocated IOLs and capsular bags that have been sent to it over the years, finding that pseudoexfoliation (or exfoliation syn- drome) is the most common factor that seems to be associated with late IOL dislocations. "We're finding that exfoliation syndrome might be related to up to two-thirds of these," he said. Dr. Mamalis said that during surgery the signs of pseudoexfoliation can be subtle and Spontaneous lens dislocation: why it occurs, when, management, and other insights An example of dead bag syndrome Source: Steven Safran, MD

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