Intraocular Lens Explantation After Cataract Surgery: Indications, Results, and Explantation Techniques

Intraocular lens (IOL) explantation after uneventful cataract surgery is rare but associated with a high risk of complications. In the past few years, the number of published reports about IOL explantation has grown significantly and most of them focus on explantation surgery due to spontaneous late IOL in-the-bag dislocations. This is related to the growth of the pseudophakic population, first as a result of longer lifespans, and second, because the improvements in safety and accuracy of phacoemulsification surgery have led to an increased number of phacorefractive procedures performed in younger patients. The improvement in phacoemulsification surgery goes in tandem with higher patient demands and expectations of the surgery. Therefore, incorrect lens power or patients who fail to neuroadapt to multifocal IOLs are also well‑recognized indications for IOL explantation and exchange. IOL opacification, although it was an epidemic in the past especially associated with certain IOL models, is currently still occurring even with some new IOL models. The outcomes of explantation surgeries are analyzed in this review separately according to the reason for explantation. Finally, the main reported IOL explantation techniques are reviewed as well.