Intraocular lens exchange through a 3.2-mm corneal incision for opacified intraocular lenses


Kubaloglu A., Sari E., Koytak A., Cinar Y., Erol K., Ozerturk Y.

INDIAN JOURNAL OF OPHTHALMOLOGY, vol.59, no.1, pp.17-21, 2011 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 59 Issue: 1
  • Publication Date: 2011
  • Doi Number: 10.4103/0301-4738.73713
  • Journal Name: INDIAN JOURNAL OF OPHTHALMOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.17-21
  • Keywords: Intraocular lens opacification, small corneal incision, intraocular lens exchange, postsurgical outcomes
  • Bursa Uludag University Affiliated: Yes

Abstract

Aim: 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. Materials and 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. Conclusion: 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.