Risk of Late Intraocular Lens Dislocation After Cataract Surgery, 1980-2009: A Population-Based Study

PURPOSE: To estimate the long-term cumulative risk of late posterior chamber intraocular lens (IOL) dislocation after cataract extraction in a population-based cohort. DESIGN: Retrospective cohort study and nested case-control study. METHODS: The records of all residents of Olmsted County, Minnesota, who underwent cataract extraction from January 1, 1980, through May 31, 2009, (14 471 cases in 9577 residents) and who were diagnosed with late posterior chamber IOL dislocation in the same period were reviewed. Cases were identified through the Rochester Epidemiology Project. Three controls chosen from the cataract surgery cohort were matched to each IOL dislocation case by age, gender, and duration of follow-up. Records were reviewed to confirm case status and to ascertain risk factor information. The cumulative risk of IOL dislocation was estimated by using the Kaplan-Meier method. Logistic regression models assessed differences between cases and controls. RESULTS: We identified 16 cases of late posterior chamber IOL dislocation, 9 with in-the-bag dislocations and 7 with out-of-the-bag dislocations. At 5, 10, 15, 20, and 25 years after cataract extraction, the cumulative risk of IOL dislocation was 0.1%, 0.1%, 0.2%, 0.7%, and 1.7%, respectively. There was no significant difference in the risk of late IOL dislocation after extracapsular cataract extraction when compared with phacoemulsification (P = .21) or between different decades of surgery (P = .92). Pseudoexfoliation and zonular laxity at surgery were associated significantly with late IOL dislocation (P = .01). CONCLUSIONS: The long-term cumulative risk of late IOL dislocation after cataract extraction was low and did not significantly change over our nearly 30-year study period. (Am J Ophthalmol 2011;152:618-623. (C) 2011 by Elsevier Inc. All rights reserved.)