Surgical management of intraocular lens dislocation in highly myopic eyes.
4 affiliations
- 1Department of Ophthalmology, Shanghai Tenth People's Hospital, Shanghai, China.
- 2Visual Rehabilitation Center, Tongji University School of Medicine, Shanghai, China.
- 3Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.
- 4Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Abstract
Objective
To evaluate the postoperative visual function, intraocular lens (IOL) positional stability and ocular safety of surgical strategies tailored to capsular support status for the treatment of IOL dislocation in patients with high myopia, and to explore the potential impact of such complex surgeries on macular microcirculation.Methods
This single-center retrospective included 28 patients (28 eyes) with high myopia and IOL dislocation who underwent surgical treatment from January 2024 to August 2025. Surgical approaches were selected based on preoperative anatomical conditions and capsular status, including IOL explantation without secondary IOL implantation in 10 eyes, in-the-bag IOL repositioning in 6 eyes, and sutured scleral fixation of a posterior chamber IOL in 12 eyes. The primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and IOL tilt and decentration before surgery and at 6 months postoperatively. Safety measures included intraocular pressure (IOP), corneal endothelial cell density (ECD), postoperative complications. Postoperative retinal microcirculation parameters assessed by WF-OCTA were included as exploratory outcomes. Whereas the IOL-position comparison included only the 18 operated eyes retaining an IOL and their corresponding 18 matched control eyes. Before quantitative analysis, all OCTA images were reviewed for image quality.Results
Compared with preoperative values, UDVA (0.59 ± 0.46 logMAR, P = 0.005) and CDVA (0.38 ± 0.59 logMAR, P = 0.031) were significantly improved at 6 months postoperatively. Postoperative IOL position was evaluated in the 18 eyes retaining an IOL; 3 (16.7%) exceeded the 6° tilt threshold and 2 (11.1%) exceeded the 0.6 mm decentration threshold. The postoperative 2D tilt of IOL was 4.51 ± 2.17°, 2D decentration was 0.45 ± 0.33 mm, 3D tilt was 4.41 ± 2.09°, and 3D decentration was 0.44 ± 0.34 mm. Corneal ECD decreased from 2672.72 ± 312.26 cells/mm² preoperatively to 2356.61 ± 420.15 cells/mm² postoperatively (P < 0.001), yet no corneal decompensation occurred. IOP remained stable during the follow-up period, and the incidence of complications was low. Regional WF-OCTA parameters varied between the operated and matched control eyes, without a consistent pattern across macular regions.Conclusion
In patients with high myopia and IOL dislocation, different surgical approaches can achieve stable intraocular optical reconstruction and improve mid-to-long-term visual function under the corresponding anatomical conditions. Although the magnitude of visual acuity improvement is limited in this population due to high myopia- related high-risk fundus factors.
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BibTeX
@article{tang2026surgical,
title = {{Surgical management of intraocular lens dislocation in highly myopic eyes.}},
author = {Shiyu Tang and Chenxi Li and Zihan Xie and Fan Yang and Yuye Zhang and Wenting Cai and Tianyu Zheng},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1922084},
url = {https://europepmc.org/article/MED/42898689},
note = {CC BY},
}
RIS
TY - JOUR
TI - Surgical management of intraocular lens dislocation in highly myopic eyes.
AU - Shiyu Tang
AU - Chenxi Li
AU - Zihan Xie
AU - Fan Yang
AU - Yuye Zhang
AU - Wenting Cai
AU - Tianyu Zheng
PY - 2026
DA - 2026/10/05
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1922084
UR - https://europepmc.org/article/MED/42898689
AB - Objective To evaluate the postoperative visual function, intraocular lens (IOL) positional stability and ocular safety of surgical strategies tailored to capsular support status for the treatment of IOL dislocation in patients with high myopia, and to explore the potential impact of such complex surgeries on macular microcirculation.Methods This single-center retrospective included 28 patients (28 eyes) with high myopia and IOL dislocation who underwent surgical treatment from January 2024 to August 2025. Surgical approaches were selected based on preoperative anatomical conditions and capsular status, including IOL explantation without secondary IOL implantation in 10 eyes, in-the-bag IOL repositioning in 6 eyes, and sutured scleral fixation of a posterior chamber IOL in 12 eyes. The primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and IOL tilt and decentration before surgery and at 6 months postoperatively. Safety measures included intraocular pressure (IOP), corneal endothelial cell density (ECD), postoperative complications. Postoperative retinal microcirculation parameters assessed by WF-OCTA were included as exploratory outcomes. Whereas the IOL-position comparison included only the 18 operated eyes retaining an IOL and their corresponding 18 matched control eyes. Before quantitative analysis, all OCTA images were reviewed for image quality.Results Compared with preoperative values, UDVA (0.59 ± 0.46 logMAR, P = 0.005) and CDVA (0.38 ± 0.59 logMAR, P = 0.031) were significantly improved at 6 months postoperatively. Postoperative IOL position was evaluated in the 18 eyes retaining an IOL; 3 (16.7%) exceeded the 6° tilt threshold and 2 (11.1%) exceeded the 0.6 mm decentration threshold. The postoperative 2D tilt of IOL was 4.51 ± 2.17°, 2D decentration was 0.45 ± 0.33 mm, 3D tilt was 4.41 ± 2.09°, and 3D decentration was 0.44 ± 0.34 mm. Corneal ECD decreased from 2672.72 ± 312.26 cells/mm² preoperatively to 2356.61 ± 420.15 cells/mm² postoperatively (P < 0.001), yet no corneal decompensation occurred. IOP remained stable during the follow-up period, and the incidence of complications was low. Regional WF-OCTA parameters varied between the operated and matched control eyes, without a consistent pattern across macular regions.Conclusion In patients with high myopia and IOL dislocation, different surgical approaches can achieve stable intraocular optical reconstruction and improve mid-to-long-term visual function under the corresponding anatomical conditions. Although the magnitude of visual acuity improvement is limited in this population due to high myopia- related high-risk fundus factors.
SN - 2296-858X
ER -