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

Purpose: To determine the indications and surgical outcomes of intraocular lens (IOL) exchange in pseudophakic patients who were operated in Labbafinejad Tertiary Referral Center between 2010 and 2015.Methods: In this retrospective interventional case series, the medical records of 198 consecutive 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 also the pre- and postoperative refractive error and best corrected visual acuity (BCVA) were considered as the main outcomes measures in this study. All postoperative data were analysed at least six months of follow-up.Results: : The mean age of our participants was 59.18±21.21 years old at the time of IOL exchange with a male percent of 61.60%. Mean follow-up after IOL exchange was 16.45±17.4 months. There was 57.10% cases with the postoperative spherical equivalent at the range of -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. The indication of IOL exchange was IOL decenteration (46.30%), corneal decompensation(28.70%), complicated first surgery(17.59%), residual refractive errors(5.09%), calcification(1.85%) and capsular phimosis(0.46%) among our study population. 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. More postoperative complication was observed in cases with posterior chamber IOLs (n=23). There was only one case having the suprachoroidal haemorrhage during IOL exchange. Conclusion: Based on our findings, IOL decentration was the most common indication of IOL exchange. Corneal decompensation, glaucoma and retinal detachment and cystoid macular edema were found as the most common complications of the IOL exchange in our study.