ASCRS/ESCRS Survey on Foldable IOLs Requiring Explantation or Secondary Intervention: 2014 Update

Sunday, April 19, 2015: 2:26 PM
Room 5A (San Diego Convention Center)
Nick Mamalis, MD
Mohammed A. Farukhi, MD
Gregory D. Kramer, MD
Kyle MacLean, MD

Purpose
To survey members of the ASCRS/ESCRS regarding explantation of foldable IOLs or foldable IOLs requiring secondary intervention.

Methods
The survey was available to ASCRS/ESCRS members throughout 2014.  Surgeons filled out one form for each explanted foldable IOL.  Preoperative data was collected, as well as type of IOL requiring explantation.  The patients’ signs and symptoms as well as complications requiring explantation were tabulated.  Lastly, postoperative results were assessed.

Results
Complications varied depending on the type of foldable IOL.  Dislocation/decentration was the most common complication associated with the one-piece silicone IOLs.  Similarly, dislocation/decentration was seen as the most common reason for removal of three-piece silicone and one-piece acrylic lenses.  Incorrect lens power as well as glare/optical aberrations were also noted in explantation of IOLs.  The number of explanted multifocal IOLs increased over the past year.  The most common reason for explantation of these lenses was glare/optical aberrations.  Hydrophilic acrylic IOLs were removed most commonly due to calcification/opacification.

Conclusion
The most common complications involving foldable IOLs have changed little over the past five years and may continue to be avoided by excellent surgical technique, quality manufacturing, careful IOL folding and insertion, and accurate IOL measurements.  Multifocal IOLs are being explanted more frequently secondary to glare/optical aberrations.