Hydrophilic acrylic intraocular lens exchange: Five-year experience

Abstract

Visual function and quality of life were better after IOL exchange. However, poor outcomes in some patients mandate an extensive informed consent procedure for clear IOL exchange.

Intraocular lens exchange with removal of the optic only

“…12 Many surgical methods have been used for IOL exchange 5,[13][14][15] ; all share the principle of dissection to avoid damage of the intraocular tissue, such as viscodissection and removal of anterior capsule adhesion. However, intraoperative complications, such as zonular dialysis, posterior capsule rupture, and iridodialysis, were encountered in approximately 30% of cases, 8,9,13 reflecting the technical difficulty of IOL exchange. Most complications occurred during removal of adhered haptics.…”

“…Yu and Ng 8 report adhesions between the posterior capsule and the haptic in 5 (33.3%) of 15 eyes that had IOL exchange surgery; of the 5 eyes, 4 (80.0%) had posterior capsule rupture or disruption of the ciliary body. Gashau et al 9 removed the haptics in most cases; 13 (25.5%) of 51 eyes developed posterior capsule rupture of the zonular dehiscence. The haptics were left in 5 eyes due to severe adhesions; of these eyes, 4 had no complications associated with the remaining haptics.…”

“…Zonular dehiscence is the most common intraoperative complication of IOL exchange surgery. 5,8,9 Dagres et al 5 observed zonular dehiscence in 11 (44%) of 25 eyes having IOL exchange. This finding implies that separating the IOL from the firmly adherent lens capsule is technically challenging.…”

“…When tension of the lens capsule was identified during removal of the haptics, the haptics were left in the eye. Gashau et al 9 also left the haptics in the eye in some cases of IOL exchange. No complications related to the remnant haptics were reported in either study.…”

Noninvasive identification of different intraocular lenses using Raman spectroscopy in porcine eyes

“…24,25 In this situation, having the preoperative information about the implanted IOL would be important for surgical planning, especially in patients with poor pupil dilation, which prevents direct observation of the IOL haptics.…”