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Leslie A. Wei, Jeffrey Olson, Michael Taravella; Changing Indications for Intraocular Lens Exchange. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6220.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the reasons for intraocular lens (IOL) exchange, outcomes, and complications at an academic eye center.
Retrospective chart review of all IOL exchanges performed at the Rocky Mountain Lions Eye Institute, University of Colorado Denver, from January 2005 to October 2010. Records were reviewed to include 3 years of follow-up after exchange.
35 eyes of 31 patients underwent IOL exchange. The average age was 66.7 years. 54.8% were female. 4 patients had undergone previous refractive surgery (LASIK or RK). At least 45.7% of the explanted IOLs were multifocal. The most common reasons for exchange were IOL dislocation 34.3%, dysphotopsia 31.4%, and anisometropia 22.9%. All cases of exchange for dysphotopsia were for multifocal IOLs. The remaining 11.4% of patients underwent exchange for pseudophakic bullous keratopathy, cystoid macular edema, chronic iritis, or lens-induced pigment dispersion with secondary glaucoma. Vitrectomy was performed concurrently in 31.4% of exchanges. The most common complications were secondary glaucoma 14.3%, residual astigmatism 11.4%, and iritis 5.7%. Mean pre-operative and 3 month post-operative BCVA was 20/53 and 20/44 respectively.
IOL exchange is done for a number of indications with good outcomes and improved BCVA in most patients. However, multifocal IOLs cause more dysphotopsia than standard IOLs. Larger studies are needed to explore the growing subset of multifocal IOL exchanges.
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