Outcomes of IOL Exchange Surgery in Tertiary Referral Center
The purpose of the study is to identify how many patients underwent Intraocular Lens exchange at Moorfields Eye Hospital during the period of September 2012 - February 2014, the reasons of the IOL exchange, the intraoperative and postoperative complications as well as the visual outcome 3 months after the operation.
Patients who underwent IOL exchange were identified from the Moorfields Eye Hospital OPENEYES electronic patient records during the period September 2012-February 2014. Data collected: a) Patients’ age, b) Operated eye, c) Detailed description of the operation, d) Indication for IOL exchange, e) Type of initial IOL used, f) Type of IOL used at the IOL exchange procedure, g) Intraoperative and Postoperative complications, h) Best corrected visual acuity before and 3 months after the IOL exchange. SPSS version 22 was used for the analysis of data.
Forty-eight IOL exchanges were identified. Patients’ mean age: 61.7 years old (range 28-87). Main procedure performed was: exchange alone (62.5%) ; exchange with anterior vitrectomy (25%) and exchange with keratoplasty (6.3%). Main causes for exchange were: subluxated lens (54.2%), multifocal IOLs inducing glare (8.3%), corneal decompensation (6.3%) and blunt trauma (6.3%). IOLs requiring exchange were Bag IOLs (87.5%), Sulcus IOLs (4.2%) and AC IOLs (6.3%); those were exchanged for AC IOLs (56.3%), Bag IOLs (20.8%), Sulcus IOLs (18.8%) and Sutured IOLs (4.2%). The majority of procedures were uncomplicated (77.1%). Minor complications occurred in 18.7% and severe complications 4.2%. Mean BCVA before IOL exchange: 0.82 LogMar improved to 0.36 LogMar at last follow-up.
In our series, IOL exchange appeared to be a safe procedure. IOL exchange surgery may led to significant BCVA improvement in eyes that had previous multiple operations and ocular co-morbidities. Subluxated IOLs were the main cause for IOL exchanges. Anterior chamber lenses were the first choice to replace bag IOLs.