To evaluate the indications, lens styles, perioperative findings, and results of intraocular lens (IOL) explantation or exchange performed in the authors department in 2005.
Methods
The retrospective analysis comprised 22 patients (23 eyes). Twenty-one eyes had previous phacoemulsification and IOL implantation, one eye secondary aphakic IOL, and one eye phakic IOL implantation. The indications for IOL explantation/exchange and perioperative complications were evaluated. The best-corrected visual acuity (BCVA) before and after surgery was compared.
Results
Time from initial surgery to explantation/exchange varied from 1 to 121 months, median value was 46 months. The IOLs were explanted using local anesthesia and in 21 eyes replaced with new lens. Indications for IOL removal were opacification of the IOL in 12 eyes, malposition of the IOL in 5 eyes, postoperative refractive error in 2 eyes, recurrent toxic anterior segment syndrome in 1 eye, pseudophakic dysphotopsia in 1 eye, endothelial cell loss in phakic anterior chamber IOL in 1 eye, and visual discomfort with intraocular telescopic lens in 1 eye. The mean BCVA (decimal scale) before and after IOL explantation/exchange was 0.562±0.279 and 0.627±0.276, respectively. There was no significant difference in visual acuity before and after IOL exchange (Wilcoxon test).
Conclusions
The most frequent indications for IOL explantation/exchange were opacification of the IOL and IOL malposition. Surgeries were uneventful in most cases. Final visual results have been largely good. Long-term follow-up of patients with various types of IOLs should be maintained.
PandeyS.K., WernerL., AppleD.J.Calcium precipitation on the optical surfaces of a foldable intraocular lens: a clinicopathological correlation. Arch Ophthalmol2002; 120: 391–3.
9.
WernerL., AppleD.J., Escobar-GomezM.Postoperative deposition of calcium on the surfaces of a hydrogel intraocular lens. Ophthalmology2000; 107: 2179–85.
10.
YuA.K.F., NgA.S.Y.Complications and clinical outcomes of intraocular lens exchange in patients with calcified hydrogel lenses. J Cataract Refract Surg2002; 28: 1217–22.
11.
PandeyS.K., WernerL., AppleD.J.Hydrophilic acrylic intraocular lens optic and haptics opacification in a diabetic patient. Ophthalmology2002; 109: 2042–51.
12.
MamalisN., CrandallA.S., PulsipherM.W.Intraocular lens explantation and exchange. A review of lens styles, clinical indications, clinical results, and visual outcome. J Cataract Refract Surg1991; 17: 811–8.
13.
MamalisN.Explantation of intraocular lenses. Curr Opin Ophthalmol2000; 11: 289–95.
14.
IzakA.M., WernerL., PandeyS.K.Calcification of modern foldable hydrogel intraocular lens designs. Eye2003; 17: 393–406.
15.
DagresE., KhanM.A., KyleG.M.Perioperative complications of intraocular lens exchange in patients with opacified Aqua-Sense lenses. J Cataract Refract Surg2004; 30: 2569–73.
16.
YuA.K.F., KwanK.Y.W., ChanD.H.Y.Clinical features of 46 eyes with calcified hydrogel intraocular lenses. J Cataract Refract Surg2001; 27: 1596–606.
17.
NeuhannI.M., WernerL., IzakAM.Late postoperative opacification of a hydrophilic acrylic (hydrogel) intraocular lens. Ophthalmology2004; 111: 2094–101.
18.
TetzM.R., O'MorchoeD.J.C., GwinT.D.Posterior capsular opacification and intraocular lens decentration. Part II: experimental findings on a prototype circular intraocular lens design. J Cataract Refract Surg1988; 14: 614–23.
19.
OhmiS.Decentration associated with asymmetric capsular shrinkage and intraocular lens size. J Cataract Refract Surg1993; 19: 640–3.
20.
AssiaE.I., AppleD.J., BardenA.An experimental study comparing various anterior capsulectomy techniques. Arch Ophthalmol1991; 109: 642–7.
21.
CaballeroA., LópezM.C., LosadaM.Long-term decentration of intraocular lenses implanted with envelope capsulotomy and continuous curvilinear capsulotomy: a comparative study. J Cataract Refract Surg1995; 21: 287–92.
22.
JungC.K., ChungS.K., BaekN.H.Decentration and tilt: Silicone multifocal versus acrylic soft intraocular lenses. J Cataract Refract Surg2000; 26: 582–5.
23.
AramberriJ.Intraocular lens power calculation after corneal refractive surgery: Double-K method. J Cataract Refract Surg2003; 29: 2063–8.
24.
ArgentoC., CosentinoM.J., BadozaD.Intraocular lens power calculation after refractive surgery. J Cataract Refract Surg2003; 29: 1346–51.
25.
PackerM., BrownL.K., HoffmanR.S.Intraocular lens power calculation after incisional and thermal keratorefractive surgery. J Cataract Refract Surg2004; 30: 1430–4.
26.
GimbelH.V., SunR., FurlongM.T.Accuracy and predictability of intraocular lens power calculation after photorefractive keratectomy. J Cataract Refract Surg2000; 26: 1147–51.
27.
GimbelH.V., SunR.Accuracy and predictability of intraocular lens power calculation after laser in situ keratomileusis. J Cataract Refract Surg2001; 27: 571–6.
28.
AlióJ.L., de la HozF., Pérez-SantonjaJ.J.Phakic anterior chamber lenses for the correction of myopia: a 7-year cumulative analysis of complications in 263 cases. Ophthalmology1999; 106: 458–66.
29.
Pérez-SantonjaJ.J., IradierM.T., Sanz-IglesiasL.Endothelial change in phakic eyes with anterior chamber intraocular lenses to correct high myopia. J Cataract Refract Surg1996; 22: 1017–22.
30.
MenezoJ.L., CisnerosA., HuesoJ.R., HartoM.Long-term results of surgical treatment of high myopia with Worst-Fechner intraocular lenses. J Cataract Refract Surg1995; 21: 93–8.
31.
PallikarisI.G., KalyvianakiM.I., KymionisG.D.Phakic refractive lens implantation in high myopic patients: one-year results. J Cataract Refract Surg2004; 30: 1190–7.
32.
MenezoJ.L., CisnerosA.L., Rodriguez-SalvadorV.Endothelial study of iris-claw phakic lens: four year follow-up. J Cataract Refract Surg1998; 24: 1039–49.
Ka kalo luM., ÜretmenÖ, Ya ciA.Medium-term results of implantable miniaturized telescopes in eyes with age-related macular degeneration. J Cataract Refract Surg2001; 27: 1751–5.
37.
AlióJ.L., MuletE.M., Ruiz-MorenoA.M.Intraocular telescopic lens evaluation in patients with age-related macular degeneration. J Cataract Refract Surg2004; 30: 1177–89.
38.
HolladayJ.T., van DijkH., LangA.Optical performance of multifocal intraocular lenses. J Cataract Refract Surg1990; 16: 413–22 [erratum 781].
39.
SteinertR.F., AkerB.L., TrentacotsD.J.A prospective comparative study of the AMO ARRAY zonal-progressive multifocal silicone intraocular lens and a monofocal intraocular lens. Ophthalmology1999; 106: 1243–55.
40.
JavittJ.C., WangF., TrentacostD.J.Outcomes of cataract extraction with multifocal intraocular lens implantation: functional status and quality of life. Ophthalmology1997; 104: 589–99.
41.
SteinertR.F., PostCTJr, BrintS.F.A prospective, randomized, double-masked comparison of a zonal-progressive multifocal intraocular lens and a monofocal intraocular lens. Ophthalmology1992; 99: 853–60; discussion by Holladay JT, 860–1.
