Longitudinal Trends of Intraocular Lens Implant Dislocation in a Large, Federated Electronic Health Record Network

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Investigative Ophthalmology and Visual Science

Abstract

Purpose : Previous studies have estimated the incidence of intraocular lens (IOL) dislocation after cataract surgery, but many of these estimates include data from many decades ago. To provide an updated estimate of the current incidence of IOL dislocation and to characterize longitudinal trends in IOL dislocation and related surgical intervention, we conducted a retrospective cohort study using deidentified data from the large, federated TriNetX electronic health record network.

Methods : We identified a retrospective cohort of 761,443 patients from 66 health care organizations in the United States from the period between January 1, 2000 and December 31, 2023 who had undergone cataract extraction and IOL implantation and, thus, were at risk for IOL dislocation. Within our retrospective cohort, we identified patient who had experienced IOL dislocation based on International Classification of Diseases, Tenth Revision (ICD-10) codes and those who had undergone surgical intervention for dislocated IOL based on Current Procedural Terminology (CPT®) codes; and analyzed longitudinal trends using the Mann-Kendall test. We also identified patients with risk factors for IOL dislocation, such as history of ocular trauma, intravitreal injections, pseudoexfoliation glaucoma, and Marfan syndrome, based on ICD-10 and CPT® codes.

Results : 5,216 (0.7%) of the 761,443 patients in our retrospective cohort experienced IOL dislocation between the period of January 1, 2000 to December 31, 2023. Overall, there was a significant monotonic increase in incidence across this period of over two decades (p = 0.0001). A similar pattern of increasing incidence was seen across all demographic stratifications: in both males and females, in patients of Hispanic/Latino ethnicity and not Hispanic/Latino ethnicity, in all race categories, and across all ages. Among patients who were diagnosed with IOL dislocation, there was also a significant monotonic increase in incidence rate of surgical intervention (p < 0.0001), ocular trauma (p < 0.0001), and intravitreal injections (p < 0.0001).

Conclusions : There has been an increasing incidence of IOL dislocation and surgical intervention for dislocated IOL implants. We emphasize the need for practitioners to be prepared to manage these conditions and for the future development of new, optimized secondary IOL techniques to provide the best possible outcomes for these patients.

Volume

66

Issue

8

First Page

5062

Comments

Association for Research in Vision and Ophthalmology ARVO Annual Meeting, May 4-8, 2025, Salt Lake City, UT

Last Page

5062

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