Korean J Ophthalmol.  2008 Dec;22(4):228-235. 10.3341/kjo.2008.22.4.228.

Clinical Efficacy and Complications of Intraocular Lens Exchange for Opacified Intraocular Lenses

Affiliations
  • 1Department of Ophthalmology, Seoul Veterans Hospital, Seoul, Korea. drskchoi@hanmail.net

Abstract

PURPOSE: To evaluate the clinical efficacy and complications of intraocular lens (IOL) exchange. METHODS: A review of medical records was performed for 52 eyes that had undergone an IOL exchange due to IOL opacification. Surgical complications and their incidences were analyzed. The mean best corrected visual acuity (BCVA) after the IOL exchange was compared with the mean pre-exchange BCVA and with the mean BCVA after the initial IOL implantation. Prediction error of refraction and biometric data obtained for the IOL exchange were, if available, compared with those obtained for the initial IOL implantation. The prediction error for the IOL exchange, calculated from the biometric data obtained before the IOL exchange, was compared with that calculated from the measurements obtained before the initial IOL implantation. RESULTS: The overall complication rates were low and no serious complications were found. The mean BCVA improved significantly after the IOL exchange and was not significantly different from that obtained after the initial IOL implantation. However, the refractive prediction for the IOL exchange was not as good as it was for the initial IOL implantation, which was thought to be related with difficulties in axial length (AL) measurements. Biometric data taken before the initial IOL implantation was associated with a significantly better refractive prediction than those taken before the IOL exchange. CONCLUSIONS: IOL exchange was both efficacious and safe for visual recovery. However, IOL exchange was related with increased difficulty of predicting postoperative refraction; difficulties in AL measurements are the suggested cause.

Keyword

Axial length measurement; Intraocular lens exchange; Intraocular lens implantation; Intraocular lens opacification; Prediction error of refraction

MeSH Terms

Aged
Aged, 80 and over
Device Removal
Female
Humans
*Intraoperative Complications
*Lenses, Intraocular
Male
Middle Aged
*Postoperative Complications
*Prosthesis Failure
Refraction, Ocular
Reoperation
Time Factors
Treatment Outcome
Visual Acuity/physiology

Reference

1. Kim JC, Kim CS, Choi SH, et al. Clinical characteristics of patients with opacification of hydrophilic acrylic intraocular lens after cataract surgery. J Korean Ophthalmol Soc. 2005; 46:1281–1290.
2. Lee JY, Joo KM, Kim SH. Late Opacification of hydrophilic acrylic intraocular lenses. J Korean Ophthalmol Soc. 2002; 43:2419–2429.
3. Kim HG, Lee SH, Choi YJ. Late Postoperative opacification of the foldable hydrophilic acrylic intraocular lens, ACRL-160. J Korean Ophthalmol Soc. 2003; 44:315–320.
4. Lee DH, Seo Y, Joo CK. Progressive opacification of hydrophilic acrylic intraocular lenses in diabetic patients. J Cataract Refract Surg. 2002; 28:1271–1275. PMID: 12106740.
Article
5. Yu AK, Ng AS. Complications and clinical outcomes of intraocular lens exchange in patients with calcified hydrogel lenses. J Cataract Refract Surg. 2002; 28:1217–1222. PMID: 12106731.
Article
6. Yu AK, Shek TW. Hydroxyapatite formation on implanted hydrogel intraocular lenses. Arch Ophthalmol. 2001; 119:611–614. PMID: 11296031.
Article
7. Apple DJ, Werner L, Escobar-Gomez M, Pandey SK. Deposits on the optical surfaces of Hydroview intraocular lenses. J Cataract Refract Surg. 2000; 26:796–797. PMID: 10991679.
Article
8. Fernando GT, Crayford BB. Visually significant calcification of hydrogel intraocular lenses necessitating explantation. Clin Exp Ophthalmol. 2000; 28:280–286.
Article
9. Jin GJC, Crandall AS, Jones JJ. Changing indications for and improving outcomes of intraocular lens exchange. Am J Ophthalmol. 2005; 140:688–694. PMID: 16226520.
Article
10. Carlson AN, Stewart WC, Tso PC. Intraocular lens complications requiring removal of exchange. Surv Ophthalmol. 1998; 42:417–440. PMID: 9548571.
11. Mamalis N. Explantation of intraocular lenses. Curr Opin Ophthalmol. 2000; 8. 11:289–295. PMID: 10977774.
Article
12. Raman S, Redmond R. Reasons for secondary surgical intervention after phacoemulsification with posterior chamber lens implantation. J Cataract Refract Surg. 2003; 29:513–517. PMID: 12663016.
Article
13. Gashau AJ, Anand A, Chawdhary S. Hydrophilic acrylic intraocular lens exchange: five-year experience. J Cataract Refract Surg. 2006; 32:1340–1344. PMID: 16863972.
Article
14. Grading diabetic retinopathy from stereoscopic color fundus photographs: an extension of the modified Airlie House classification: ETDRS report number 10. Ophthalmology. 1991; 98:786–806. PMID: 2062513.
15. Izak AM, WernerL , Pandey SK, Apple DJ. Calcification of modern foldable hydrogel intraocular lens design. Eye. 2003; 17:393–406. PMID: 12724703.
16. Yu AK, Kwan KY, Chan DH, Fong DY. Clinical features of 46 eyes with calcified hydrogel intraocular lenses. J Cataract Refract Surg. 2001; 27:1596–1606. PMID: 11687358.
Article
17. Frohn A, Dick HB, Augustin AJ, Grus FH. Late opacification of the foldable hydrophilic acrylic lens SC60B-OUV. Ophthalmology. 2001; 108:1999–2004. PMID: 11713068.
Article
18. Mamalis N. Hydrophilic acrylic intraocular lenses. J Cataract Refract Surg. 2001; 27:1339–1340. PMID: 11566513.
Article
19. Werner L, Apple DJ, Kaskloglu M, Pandey SK. Dense opacification of the optical component of a hydrophilic acrylic intraocular lens; a clinicopathological analysis of 9 explanted lenses. J Cataract Refract Surg. 2001; 27:1485–1492. PMID: 11566535.
20. Apple DJ, Werner L, Pandery SK. Newly recognized complication of posterior chamber intraocular lenses. Arch Ophthalmol. 2001; 119:581–582. PMID: 11296025.
21. Habib NE, Freegard TJ, Gock G, et al. Late surface opacification of Hydroview® intraocular lenses. Eye. 2002; 16:69–74. PMID: 11913892.
Article
22. Dagres E, Khan MA, et al. Perioperative complications of intraocular lens exchange in patients with opacified Aqua-Sense lenses. J Cataract Refract Surg. 2004; 30:2569–2573. PMID: 15617926.
Article
23. Dahlmann AH, Dhingra N, Chawdhary S. Acrylic lens exchange for late opacification of the optic. J Cataract Refract Surg. 2002; 28:1713–1714. PMID: 12231341.
Article
24. Preussner P-R, Wahl J, Weitzel D, et al. Predicting postoperative intraocular lens position and refraction. J Cataract Refract Surg. 2004; 30:2077–2083. PMID: 15474817.
Article
25. Suto C, Hori S, Fukuyama E, Akura J. Adjusting intraocular lens power for sulcus fixation. J Cataract Refrac Surg. 2003; 29:1913–1917.
Article
26. Kora Y, Shimizu K, Yoshica M, et al. Intraocular lens power calculation for lens exchange. J Cataract Refract Surg. 2001; 27:543–548. PMID: 11311621.
Article
27. Holladay JT. Standardizing constants for ultrasonic biometry, keratometry, and intraocular lens power calculations. J Cataract Refract Surg. 1997; 23:1356–1370. PMID: 9423908.
Article
28. Lowery MD, Makker H, Lang A. Effect of the speed of sound in Sensar acrylic lenses on pseudophakic axial length measurements. J Cataract Refract Surg. 2002; 28:1269–1270. PMID: 12106739.
Article
29. Lee SB, Choi SH. Ultrasonic determination of axial length in pseudophakia. J Korean Ophthalmol Soc. 2000; 41:1164–1169.
30. Hoffer KJ. Ultrasound velocities for axial eye length measurement. J Cataract Refract Surg. 1994; 20:554–562. PMID: 7996413.
31. Holladay JT, Prager TC. Accurate ultrasonic biometry in pseudophakia. Am J Ophthalmol. 1989; 107:189–190. PMID: 2643882.
Article
32. Holladay JT, Prager TC. Accurate ultrasonic biometry in pseudophakia. Am J Ophthalmol. 1993; 115:536–537. PMID: 8470729.
Article
Full Text Links
  • KJO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr