Rates and causes of intraoperative removal of foldable and rigid intraocular lenses: clinicopathological analysis of 100 cases.
OBJECTIVE
To analyze the rates of and reasons for intraoperative explantation of foldable and rigid intraocular lenses (IOLs) to determine the complication profile of each IOL design.


METHODS
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.


METHODS
The study comprised data analysis of foldable (n = 85) and rigid (n = 15) IOL specimens that were explanted immediately after primary implantation.


RESULTS
Eighty-five foldable intraoperative explants were accessioned. These comprised 14.5% of the 586 foldable IOL explants received between January 1988 and September 2000. There were 15 rigid poly(methyl methacrylate) (PMMA) intraoperative explants out of 2077 rigid explant specimens (0.7%). Fifty-one (60%) of the foldable IOLs requiring intraoperative explantation were the 1-piece silicone plate-haptic large-hole design, and 29 (34.1%) were the 3-piece silicone polyimide-haptic design. The most frequent reason for explantation of both designs was optic damage, 37.3% in the large-hole design and 55.2% in the polyimide design. Optic damage did not occur in rigid PMMA IOLs.


CONCLUSIONS
Some foldable IOL designs have a higher risk of damage during surgical insertion than rigid designs. Two modern foldable IOLs, the silicone plate-haptic large-hole and the silicone polyimide-haptic, appear to be more prone to damage during folding, loading, and implantation than other IOLs.
Schmidbauer
Josef M
JM
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina 29425-5536, USA.
Peng
Qun
Q
Apple
David J
DJ
Pandey
Suresh K
SK
Escobar-Gomez
Marcela
M
Auffarth
Gerd U
GU
Werner
Liliana
L
Vargas
Luis G
LG
D020878:Device Removal / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D007910:Lenses, Intraocular; D019904:Polymethyl Methacrylate; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012307:Risk Factors; D012826:Silicone Elastomers
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate