Indications and Outcomes of Intraocular Lens Exchange among Pseudophakic Eyes in a Tertiary Referral Center

Abstract

Abstract Purpose: To determine the indications and surgical outcomes of intraocular lens (IOL) exchange in pseudophakic patients at Labbafinejad Tertiary Referral Center between 2014 and 2019. Methods: In this retrospective interventional case series, the medical records of 193 patients with a history of IOL exchange were reviewed. Preoperative data, including clinical characteristics, indications of the first and second IOL implantation, intra- and postoperative complications due to IOL exchange, and the pre-and postoperative refractive error and best-corrected visual acuity (BCVA) were considered the outcome measures in this study. All postoperative data were analyzed at least six months after follow-up. Results: The mean age of our participants was 59.13 ± 20.97 years old at the time of the IOL exchange, with a male percent of 62.7 %. Mean follow-up after IOL exchange was 15.72 ± 16.28 months. The main indications of IOL exchange were IOL decentration (50.3 %), corneal decompensation (30.6 %), and residual refractive errors (8.3 %). 57.10% of patients with the postoperative spherical equivalent at -2.00 diopter (D) to +2.00D. The mean best-corrected visual acuity was 0.82 ± 0.76 LogMAR before IOL exchange and was improved to 0.73 ± 0.79 LogMAR after the surgery. Corneal decompensation (36.80%), glaucoma (26.30%), retinal detachment (21.10%), cystoid macular edema (10.50%), and uveitis (5.30%) were found as the postoperative complications. There was only one case having the suprachoroidal hemorrhage during IOL exchange. Conclusions: IOL decentration followed by corneal decompensation were the most common indications of IOL exchange. After IOL exchange, the most complications during follow-up were corneal decompensation, glaucoma, retinal detachment, and cystoid macular edema.