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Intraocular lens explantation in Spain: indications and outcomes at a tertiary referral center from 2010 to 2018

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Abstract

Purpose

To evaluate the causes of IOL explantation, techniques for secondary IOL implantation, visual outcomes and complications.

Methods

Setting: Department of Ophthalmology Complexo Hospitalario Universitario A Coruña, Spain. Design: Retrospective study. All explanted IOLs from January 2010 to June 2018 were included. Medical records were reviewed to determine the surgical indication for IOL explantation, type of IOL implanted, time between surgeries, visual outcomes and surgical complications.

Results

One hundred forty-one IOLs were explanted (134 patients). Mean time from original surgery to IOL explantation was 7.89 ± 5.81 years. Causes of IOL explantation were IOL dislocation (81.56%)—in-the-bag IOL dislocation (71.63%), out-of-the-bag IOL dislocation (9.9%)—corneal decompensation (12.05%), refractive surprise (3.5%), uveitis-glaucoma-hyphema syndrome (1.4%), IOL opacification (1.4%). Procedures for secondary IOL implantation were retropupillar iris-claw IOL (63.8%), flanged scleral fixated IOL (9.2%), three-piece IOL in ciliary sulcus (8.5%), angle-supported anterior chamber IOL (7.1%), in-the-bag IOL (3.5%), scleral fixated IOL with sutures (0.7%). Ten cases (7.1%) were left aphakic. Mean preoperative and postoperative logMAR CDVA were 1.34 ± 0.87 and 0.63 ± 0.69, respectively (p = 0.000). Mean preoperative IOP and postoperative IOP were 16.78 ± 4.49 and 15.53 ± 3.476 mmHg, respectively (p = 0.005). Complications include cystoid macular edema (7.8%), glaucoma (7.1%), IOL luxation (2.1%), retinal detachment (1.4%), trophic ulcer and leucoma (1.4%), corneal decompensation (1.4%).

Conclusions

In-the-bag IOL dislocation was the most frequent indication for IOL explantation, followed by pseudophakic bullous keratopathy. Simultaneous IOL exchange for a retropupillar iris-claw IOL was the most frequent procedure for secondary IOL implantation. Mean CDVA improved significantly and IOP decreased significantly after IOL explantation. The most frequent postoperative complication was cystoid macular edema.

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Authors and Affiliations

  1. Department of Ophthalmology Hospital Abente y Lago, Complexo Hospitalario Universitario A Coruña, Plaza del Parrote s/n, 15006, A Coruña, Spain

    Mª Victoria de Rojas, Sara Viña, Patricia Simón & Marcelino Álvarez

  2. Department of Ophthalmology, Hospital Povisa, Vigo, Spain

    Antía Gestoso

Authors
  1. Mª Victoria de Rojas
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  2. Sara Viña
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  3. Antía Gestoso
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  4. Patricia Simón
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  5. Marcelino Álvarez
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Correspondence to Mª Victoria de Rojas.

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Given the retrospective nature of the research design, informed consent and institutional review board approval were unnecessary.

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de Rojas, M., Viña, S., Gestoso, A. et al. Intraocular lens explantation in Spain: indications and outcomes at a tertiary referral center from 2010 to 2018. Int Ophthalmol 40, 313–323 (2020). https://doi.org/10.1007/s10792-019-01181-x

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  • DOI: https://doi.org/10.1007/s10792-019-01181-x

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