Complications of foldable intraocular lenses requiring explanation or secondary intervention--1998 survey

A survey of the complications associated with foldable intraocular lenses (IOLs) that required explantation or secondary intervention was sent to domestic members of the American Society of Cataract and Refractive Surgery in 1998. Preoperative data as well as patient signs and symptoms were obtained and postoperative results and outcomes assessed. The types of foldable IOLs explanted were tabulated. The percentage of each type removed and the common reasons for removal were as follows: 38%--3-piece monofocal silicone IOLs for incorrect lens power followed by dislocation/decentration; 31%--3-piece multifocal silicone IOLs for glare/optical aberrations; 16%--3-piece acrylic IOLs for glare/optical aberrations followed by incorrect lens power and dislocation; 15%--1-piece or plate-haptic silicone IOLs for dislocation/decentration followed by incorrect lens power. Visual outcomes were uniformly good in the 4 groups. Meticulous surgical technique, IOL insertion, and IOL power measurements, along with proper patient selection, are important factors in avoiding complications with foldable IOLs.