By Dr Ong Lieh Bin
Consultant Ophthalmologist & Vitreoretinal Surgeon MD (USM), M Med Ophth (USM), Vitreoretina (Australia)
Cataract surgery is a very common surgery performed by ophthalmologists all over the world. In most cases, after the cataract is removed, an artificial lens called an intraocular lens (IOL) is implanted into the capsular bag. The procedure is fast and relatively painless and most patients regain their vision within 1 week.
Dislocation of the implanted lens is uncommon but represents one of the most serious complications following cataract surgery. This may occur months or years following an uneventful cataract surgery.
The incidence is higher in patients with pseudoexfoliative syndrome (an eye disease which makes the lens unstable and also associated with glaucoma, accounts for 50% of the cases), previous complicated cataract surgery, old age, previous eye injury, previous acute angle closure attack or uveitis, short-sightedness, diabetes mellitus and connective tissue diseases.
The IOL commonly dislocates into the back of the eye. Rarely, the IOL may dislocate into the front of the eye. Anterior (front) dislocated IOL may lead to corneal damage and persistent inflammation while posterior (back) dislocated IOL may lead to retinal detachment and swelling of the macula.
Patients usually present with fluctuation in their vision, double vision, or sudden loss of vision. Occasionally, they may present with ocular pain.
Management of such cases involves removal of the dislocated IOL via surgery. Depending on situation, different types of IOLs can be implanted into the eye either during the same surgery or in another setting. Visual acuity is usually restored back to normal after a few weeks.
Dr Ong Lieh Bin’s clinic: Suite 2-07, KPJ Ipoh Specialist Hospital, 26, Jalan Raja Dihilir, 30350 Ipoh. Tel: 05 240 8777 (Ext 8335)