Title
Surgical outcomes of intraocular lens exchange: five-year study Surgical outcomes of intraocular lens exchange: five-year study
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Fairfax, Va ,
Subject
Human medicine
Source (journal)
Journal of cataract and refractive surgery. - Fairfax, Va
Volume/pages
35(2009) :6 , p. 1013-1018
ISSN
0886-3350
ISI
000266797900022
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Purpose To report the indications, surgical complications, and outcomes of intraocular lens (IOL) exchange procedures performed over 5 years and to correlate the incidence of perioperative anterior vitrectomy in eyes previously treated by neodymium:YAG (Nd:YAG) laser capsulotomy. Setting Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium. Methods In this prospective study, all IOL exchange procedures performed between October 2002 and December 2007 were included. Surgical outcomes were correlated with indications, IOL position, targeted versus achieved refraction, preoperative Nd:YAG laser capsulotomy, and surgical complications. Results One hundred twenty-eight eyes (113 patients) had IOL exchange because of IOL opacification (31%), IOL decentration (19%), IOL dislocation (18%), capsule phimosis (14%), corneal endothelial cell decompensation (8%), IOL miscalculation (6%), damaged IOL (2%), or IOL-related chronic uveitis (2%). Before and after IOL exchange, respectively, the IOL was capsule fixated in 82% and 45% of eyes, iris fixated in 4% and 39% of eyes, and sulcus fixated in 7% and 15% of eyes. Iris-fixated IOLs had the lowest predictability of refractive outcome (mean 1.55 diopters). Intraocular lenses implanted using the bag-in-the-lens technique had the highest refractive outcome predictability (mean 0.51 D). Conclusions Decentration of pseudoaccommodating IOLs accounted for 14% of all IOL exchanges. Vitreous loss necessitating anterior vitrectomy was strongly correlated with preoperative Nd:YAG laser capsulotomy. Postoperative visual acuity improved in all cases without preoperative ocular comorbidity.
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