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Raisa Epistola, Deana Choi, Mark Slabaugh; Visual Outcomes of Intraocular Lens Exchange and Repositioning. Invest. Ophthalmol. Vis. Sci. 2013;54(15):862.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the indications and outcomes of intraocular lens exchange and repositioning. To determine whether exchange of anterior chamber intraocular lens versus posterior chamber intraocular lens affects visual outcome.
We analyzed a retrospective case series of patients with intraocular lens exchange or repositioning performed at the University of Washington and Harborview Medical Center over an eight year period. Medical records were reviewed to obtain clinical and demographic data. Patients without vision at post-operative month one were excluded.
49 eyes of 46 patients who underwent intraocular lens exchange or repositioning were identified and included. 21 patients (45.7%) were female and 25 (54.3%) were male. Surgery was performed by seven different surgeons: two retina surgeons (ELC, GAV) and five anterior segment surgeons (TTS, PPC, MAS, MCW, RCM). Average age was 57.3 (range 12-89) years at time of lens exchange. Anterior chamber lenses were exchanged or repositioned in 8 (16%) eyes and posterior chamber lenses in 41 (84%) eyes. Interval between initial intraocular lens placement and lens exchange/repositioning was 108 (+/- 107) months in the anterior chamber intraocular lens group and 31.9 (+/- 416) months in the posterior chamber intraocular lens group. Mean change in visual acuity -0.922 (+/- 1.190) in the ACIOL group and -0.305 (+/-0.696) in the PCIOL group (p=0.193). The most common reason for IOL exchange/repositioning in ACIOL group was malposition causing pseudophakic bullous keratopathy (PBK) and IOL dislocation/decentration in the PCIOL group.
In this series of patients , there was no significant difference in visual outcomes when explanting ACIOLs versus PCIOLs. IOL exchange/repositioning is a safe and effective surgery that is associated with improved or stable visual acuity.
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