title: Intraocular lens explantation and exchange. A review of lens styles, clinical indications, clinical results, and visual outcome.
abstract: We conducted a retrospective review of 102 patients who had intraocular lens (IOL) explantation or exchange over a 7.5 year period. Seventy-one patients had IOL exchange while 31 had lens removal without exchange. Anterior chamber IOLs comprised 66.7% of the lenses removed. The most frequent indication for anterior chamber IOL explantation was pseudophakic bullous keratopathy (PBK), followed by the uveitis-glaucoma-hyphema syndrome and cystoid macular edema. Of the IOLs removed, 17.6% were iris-supported, with PBK being the most common indication for removal. Posterior chamber IOLs comprised 15.7% of the explanted lenses in this series. Lens dislocation/decentration was the leading indication for IOL removal in the posterior chamber IOL group. Among the 71 patients who had IOL exchange, 71.8% received an anterior chamber lens and 28.2% received a posterior chamber lens. Visual outcome following IOL exchange or removal showed that 40 patients (39%) improved, 47 patients (46%) had the same vision, and 15 patients (15%) had worse vision postoperatively. The most common reason for a worsening of vision postoperatively was corneal decompensation, followed by glaucoma and cystoid macular edema. Analysis of the clinical results revealed that 86.3% of the patients who had an exchange with an anterior chamber IOL had a successful outcome with either improvement or stabilization of the ocular condition. Ninety percent of the patients who received a posterior chamber IOL had a successful clinical outcome.
authors.affiliation: Department of Ophthalmology, University of Utah Health Sciences Center, Salt Lake City 84132.
authors.forename: N
authors.initials: N
authors.lastname: Mamalis
authors.forename: A S
authors.initials: AS
authors.lastname: Crandall
authors.forename: M W
authors.initials: MW
authors.lastname: Pulsipher
authors.forename: S
authors.initials: S
authors.lastname: Follett
authors.forename: M C
authors.initials: MC
authors.lastname: Monson
mesh_terms: D000867:Anterior Chamber / Q000601:surgery; D005128:Eye Diseases / Q000209:etiology; D006801:Humans; D007910:Lenses, Intraocular / Q000009:adverse effects*; D011183:Postoperative Complications; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity