On The Issue of Visual Function and Complications After Dislocation of An Intraocular Lens (IOL) in The Capsular Bag Following Cataract Extraction

Late spontaneous dislocation of the intraocular lens–capsular bag complex (ICBC) remains a clinically significant complication following cataract extraction, particularly among patients with pseudoexfoliation syndrome. Although modern phacoemulsification techniques have improved surgical outcomes, progressive zonular weakness and capsular instability may lead to delayed mechanical failure years after surgery. This study analyzes the frequency, causes, severity patterns, and clinical characteristics of ICBC dislocation in 30 postoperative patients. Multimodal assessments—including slit-lamp biomicroscopy, dilated fundus evaluation, ultrasound biomicroscopy, B-scan ultrasonography, and optical coherence tomography—were employed to classify dislocation severity using a structured grading system. Results demonstrate four distinct severity grades ranging from subclinical decentration with glare symptoms to deep vitreous dislocation requiring urgent vitreoretinal intervention. Pseudoexfoliation   syndrome, capsular fibrosis, zonular rupture, and capsular contraction were the most prominent etiological factors. Higher severity grades were associated with increased risk of vitreous prolapse, ocular hypertension,  cystoid macular edema, and tractional retinal detachment. The findings emphasize the importance of long-term postoperative surveillance in high-risk individuals, early recognition of structural changes, and tailored surgical  management according to severity level. This study provides important clinical insights into the progression, diagnosis, and management of late ICBC dislocation, contributing to improved ophthalmic practice and postoperative patient care.