| Title: |
Intraocular Lens Exchange: Indications, Comparative Outcomes by Technique, and Complications. |
| Authors: |
Patel, Veshesh (AUTHOR), Pakravan, Parastou (AUTHOR), Lai, James (AUTHOR), Watane, Arjun (AUTHOR), Mehra, Divy (AUTHOR), Eatz, Tiffany Alyssa (AUTHOR), Patel, Nimesh (AUTHOR), Yannuzzi, Nicolas A (AUTHOR), Sridhar, Jayanth (AUTHOR) |
| Source: |
Clinical Ophthalmology. Mar2023, Vol. 17, p941-951. 11p. |
| Subject Terms: |
*INTRAOCULAR lenses, *SURGICAL complications, *PHOTOREFRACTIVE keratectomy, *VISUAL acuity, *MACULAR edema, *SUTURES |
| Abstract: |
Purpose: To describe the indications, outcomes, and complications associated with intraocular lens (IOL) exchange. Patients and Methods: To determine the relative frequency of postoperative complications between techniques for all patients undergoing IOL exchange from May 1, 2014 through August 31, 2020. Results: IOL exchange was performed in 511 eyes of 489 patients (59.7% men; mean age: 67.0 ± 13.9 years, median time from cataract procedure to IOL exchange: 47.5 months). Mean uncorrected visual acuity significantly improved from 20/192 Snellen equivalent (logMAR 0.981) preoperatively to 20/61 (logMAR 0.487) at last follow-up (P < 0.001). Overall, 384 eyes (78.7%) met their desired refractive outcome within ± 1.0 diopter (D). The most frequent complication was cystoid macular edema (CME) (n=39, 7.6%). Iris-sutured technique was associated with significantly greater frequency of subsequent IOL dislocation (10.3%) than 4-point scleral sutured (0%, P = 0.002), anterior chamber IOL (ACIOL, 1.5%, P = 0.01), and 2-point scleral sutured (0%, P = 0.03) techniques. Yamane scleral-fixation technique was associated with significantly greater frequency of developing IOL tilt (11.8%) than ACIOL (0%, P = 0.002), 4-point scleral sutured (1.1%, P = 0.01), 2-point scleral sutured (0%, P = 0.04), and iris-sutured (0%, P = 0.04) techniques. Conclusion: IOL exchange significantly improved uncorrected visual acuity and more than three-quarters of eyes met the refractive goal. Certain techniques were associated with complications, including subsequent dislocation associated with iris-sutured technique and IOL tilt associated with Yamane scleral-fixation technique. This information may help guide surgeons in deciding between procedural techniques for individual patients during IOL exchange preoperative planning. [ABSTRACT FROM AUTHOR] |
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