Surgical outcomes of intraocular lens exchange: five-year study.
OBJECTIVE
To report the indications, surgical complications, and outcomes of intraocular lens (IOL) exchange procedures performed over 5 years and to correlate the incidence of perioperative anterior vitrectomy in eyes previously treated by neodymium:YAG (Nd:YAG) laser capsulotomy.


METHODS
Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium.


METHODS
In this prospective study, all IOL exchange procedures performed between October 2002 and December 2007 were included. Surgical outcomes were correlated with indications, IOL position, targeted versus achieved refraction, preoperative Nd:YAG laser capsulotomy, and surgical complications.


RESULTS
One hundred twenty-eight eyes (113 patients) had IOL exchange because of IOL opacification (31%), IOL decentration (19%), IOL dislocation (18%), capsule phimosis (14%), corneal endothelial cell decompensation (8%), IOL miscalculation (6%), damaged IOL (2%), or IOL-related chronic uveitis (2%). Before and after IOL exchange, respectively, the IOL was capsule fixated in 82% and 45% of eyes, iris fixated in 4% and 39% of eyes, and sulcus fixated in 7% and 15% of eyes. Iris-fixated IOLs had the lowest predictability of refractive outcome (mean 1.55 diopters). Intraocular lenses implanted using the bag-in-the-lens technique had the highest refractive outcome predictability (mean 0.51 D).


CONCLUSIONS
Decentration of pseudoaccommodating IOLs accounted for 14% of all IOL exchanges. Vitreous loss necessitating anterior vitrectomy was strongly correlated with preoperative Nd:YAG laser capsulotomy. Postoperative visual acuity improved in all cases without preoperative ocular comorbidity.
Leysen
Inge
I
Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium.
Bartholomeeusen
Ellen
E
Coeckelbergh
Tanja
T
Tassignon
Marie-José B R
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use; D007903:Lens Capsule, Crystalline / Q000601:surgery; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology