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Causes of IOL explantation in Spain
Roberto Fernández-Buenaga1, Jorge L Alio, Francisco J Muñoz-Negrete
1Vissum Corporation, Alicante, Spain.
Purpose:
To study the reasons and the demography of pseudophakic intraocular lens (IOL) explantation in Spain.
Methods:
In this observational multicenter retrospective study, the cases studied correspond to the 15 centers that constitute the Nodo Calidad Visual y Cirugia Refractiva of the Red Tematica de Investigacion Cooperativa (RETICS) sponsored by the Spanish Ministry of Health. Clinical data from all the patients who underwent explantation were assessed. The different reasons that caused the decision of explantation were analyzed.
Results:
A total of 257 explanted pseudophakic IOLs have been studied. Patients' mean age when explantation occurred was 67.5 years (SD 13.5 [22-99]) and 135 were female (52.5%). The main causes for explantation were dislocation/decentration in 145 cases (56.3%), incorrect lens power in 33 cases (12.8%), IOL opacification in 29 eyes (11.3%), neuroadaptation failure in 16 cases (6.2%), pseudophakic bullous keratopathy in 6 eyes (2.3%), endophthalmitis in 5 cases (1.9%), and "other causes" in 23 eyes (8.9%). Treatment after explantation was posterior chamber IOL implantation in 149 eyes (58%), anterior chamber IOL implantation in 49 eyes (19.1%), aphakia in 39 eyes (15.2%), and missing information in 20 cases (7.8%). Mean time from implantation to explantation was 3.97 (SD 4.68 [0.005-21.1]) years.
Conclusions:
Dislocation/decentration (most of the time with lens in the bag) is the main cause for explantation in Spain, followed by incorrect lens power (which decreased greatly over past years) and IOL opacification. Posterior chamber IOL implantation is the most elected treatment after explantation.
