Clinical Results of IOL Scaffold to Facilitate IOL Exchange: Novel Technique  

Monday, April 20, 2015: 3:41 PM
Room 5A (San Diego Convention Center)
Priya Narang, MS
Amar Agarwal, FRCS

To analyze the outcomes of intraocular lens (IOL) exchange in patients with post refractive IOL power error unsatisfied with the optical performance by pre-placement of corrective IOL in the bag.

This was a prospective, interventional, non-comparative case series. 9 eyes of 9 patients underwent the procedure. The offending IOL was levitated in to the anterior chamber and a corrective IOL was loaded and injected beneath the previous IOL and dialed into the bag. The new IOL acts as a scaffold when the offending IOL is cut, preventing damage to the posterior capsule. Corrected and un-corrected distance visual acuity (CDVA, UDVA), intraocular pressure (IOP), specular microscopy, type of IOL explanted, time interval between the previous surgery and IOL exchange was noted. Final visual outcome at 3 months was evaluated.

In all, 2 multifocal and 7 monofocal IOL’s out of which 3 hydrophilic and 6 hydrophobic IOL’s were explanted and were replaced by a monofocal hydrophobic acrylic corrective IOL. The time interval between the initial surgery and the IOL exchange was within initial 2 weeks in 6 cases, 2 months in 2 cases and 4 months in 1 case.  All the patients attained a CDVA of 20/20. There was no significant change in IOP or specular microscopy (p>0.05). Postoperatively, the IOL was well centered in all the cases. No case of zonular dehiscence or iatrogenic posterior capsule rupture was seen.

This technique is a viable option in patients with visual complaints attributable to an IOL power surprise or dissatisfaction with the optical performance of the IOL.