Intraocular lens explantation in Chinese patients: different patterns and different responses

The aim of the study was to evaluate the indications and outcomes of intraocular lens (IOL) explantation in Chinese patients. The medical records of all Chinese patients who underwent IOL explantation in Hong Kong Eye Hospital, from January 2008 to March 2013, were reviewed. A total of 98 IOLs were explanted over the study period. The main reasons for lens removal included lens malposition (71.4%), isolated uveitis-glaucoma-hyphema (UGH) syndrome (9.1%), refractive surprise (6.1%), and pseudophakic bullous keratopathy (4.1%). "In-the-bag" IOL malposition was associated with intraocular complications during cataract extraction (28.9%) and high myopia (22.2%). Sulcus implantation of a single-piece acrylic (SPA) IOL resulted in UGH syndrome in all cases, while sulcus-fixated 3-piece lenses had such complication in only 7.1% of cases. Importantly, the problem persisted despite the removal of the SPA IOL from the ciliary sulcus. Majority of the patients had resolution of the original problems after lens removal or exchange and had the same or improved visual acuity after surgery. Lens malposition was the major indication of intraocular lens explantation in our case series. Resolution of symptoms and visual acuity can be achieved with IOL explantation. Implantation of SPA in ciliary sulcus is not recommended.