Intraocular lens exchange or explantation post cataract surgery
Arundhati Dvivedi1,2, Somasheila I Murthy1,2, Sukesh Manga1
1Department of Cataract, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad 500034, Telangana, India.
International Journal of Ophthalmology
|November 19, 2024
Summary
Intraocular lens (IOL) exchange or explantation is rare (0.15%) after cataract surgery. Subluxation is the main reason, but good visual outcomes (>70%) are achievable with appropriate secondary IOL selection.
Area of Science:
- Ophthalmology
- Surgical Outcomes
- Intraocular Lenses
Background:
- Cataract surgery is a common procedure, but complications requiring intraocular lens (IOL) exchange or explantation can occur.
- Understanding the incidence, indications, and outcomes of these revision surgeries is crucial for improving patient care.
Purpose of the Study:
- To determine the incidence, indications, and visual outcomes of IOL exchange/explantation surgery.
- To compare outcomes between trainee and experienced surgeons performing these procedures.
Main Methods:
- Retrospective analysis of 60 eyes undergoing IOL exchange/explantation between January 2017 and December 2022.
- Data collected included indications, intraoperative complications, secondary IOL types, and visual acuity outcomes.
Main Results:
- The incidence of IOL exchange/explantation was 0.15% (60 out of 39,778 surgeries).
- Common indications were subluxated (43.3%) and dislocated (33.3%) IOLs. Posterior capsular rupture was a frequent intraoperative risk factor.
- Good visual acuity (>20/60) was achieved in 71.66% of eyes, with no significant difference between trainee and experienced surgeons.
Conclusions:
- IOL subluxation is the most frequent indication for IOL exchange/explantation.
- Despite complications, appropriate secondary IOL selection leads to favorable visual outcomes in over 70% of cases.
- Surgical experience level did not significantly impact visual outcomes in this cohort.
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