title: Intraocular lens exchange through a 3.2-mm corneal incision for opacified intraocular lenses.
abstract: OBJECTIVE
  The aim was to evaluate visual and refractive results and complications of intraocular lens (IOL) exchange through a 3.2 mm corneal incision for opacified IOLs.
  
  
  METHODS
  This retrospective study comprised 33 eyes of 32 patients with IOL opacification requiring an IOL exchange between July 2003 and March 2007. Exchange surgery was performed through a 3.2-mm temporal clear corneal incision followed by implantation of a new foldable hydrophobic IOL. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), topographical astigmatism, and refractive cylinder were evaluated. Surgically induced astigmatism (SIA) was calculated and complications were recorded.
  
  
  RESULTS
  Opacification was observed in 25 eyes (76%) with Aqua-Sense, 3 eyes (9%) with Hydroview, 3 eyes (9%) with MemoryLens IOLs, and 2 eyes (6%) with DgR. The mean follow-up period was 36.54 months. An uneventful IOL exchange was achieved in 18 eyes (55%). Zonular dehiscence occurred in 9 eyes (27%), and posterior capsule tear developed in 4 eyes (12%). The mean preoperative BSCVA (mean ± standard deviation, decimal scale) was 0.13 ± 0.08 (mean: 20/150, range 20/2000 to 20/60) and improved to 0.63 ± 0.18 (mean: 20/32, range 20/60 to 20/20, P < 0.001). The mean SIA was 0.70 D. Seven eyes (21%) had 0.5 D or lower SIA.
  
  
  CONCLUSIONS
  IOL exchange is a technically challenging procedure with potential risks of reversing the advantages of a prior small-incision cataract surgery. The use of a small corneal incision for IOL exchange could preserve the advantages of modern phacoemulsification surgery with acceptable SIA related to the procedure.
authors.affiliation: Kartal Dr. Lütfi Kirdar Training and Research Hospital, 2nd Eye Clinic, Cevizli, Istanbul, Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Kubaloglu
authors.forename: Esin Sogutlu
authors.initials: ES
authors.lastname: Sari
authors.forename: Arif
authors.initials: A
authors.lastname: Koytak
authors.forename: Yasin
authors.initials: Y
authors.lastname: Cinar
authors.forename: Kazim
authors.initials: K
authors.lastname: Erol
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ozerturk
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000209:etiology; D003315:Cornea / Q000601:surgery*; D020878:Device Removal / Q000379:methods*; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies