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