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Graefe's Archive for Clinical and Experimental Ophthalmology

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Open Access 01-01-2019 | Cataract

Secondary intraocular lens implantation: a large retrospective analysis

Authors: Efstathios Vounotrypidis, Iris Schuster, Marc J. Mackert, Daniel Kook, Siegfried Priglinger, Armin Wolf

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 1/2019

Abstract

Purpose

To investigate preoperative ocular risk factors and indications for secondary intraocular lens (IOL) implantation and compare postoperative complications, visual and refractive outcomes in a tertiary referral center.

Methods

Patients older than 14 years that underwent secondary IOL implantation and had a minimum follow-up of 3 months were enrolled in this retrospective case series. Preoperative ocular risk factors, indications for surgery, postoperative complications, and visual and refractive outcomes including prediction error (PE) and absolute error (AE) were evaluated. IOLs were fixated in following positions: anterior chamber (AC), retropupillary iris-claw (IC), sulcus, and capsular bag or sclera.

Results

One-hundred eighty-two eyes of 174 patients with mean follow-up of 17 ± 13.6 months were evaluated. Leading cause for surgery was IOL dislocation (75%), followed by secondary aphakia (19%) and IOL opacifications (6%). Previous vitrectomy was the major preoperative ocular risk factor (43%). Mean corrected distance visual acuity improved from preoperative 0.68 ± 0.55 to 0.42 ± 0.31LogMAR by the last follow-up (p = 0.001). PE and AE differed highly depending on the indication for surgery (p = 0.041 and p = 0.008, respectively) and the IOL fixation (p = 0.011 and p = 0.028, respectively), with IC-IOLs showing the lowest PE and AE. Postoperative AC-hemorrhage occurred mainly after IC-IOLs (p = 0.003), and postoperative hypotony was significantly higher in eyes with previous uveitis (p = 0.026).

Conclusions

Previous vitrectomy seems to be a major underreported risk factor in eyes that undergo secondary IOL implantation. Refractive outcomes depend on indication for surgery and fixation type, with retropupillary IC-IOLs providing the best refractive results, though not statistically significant compared to other IOL positions.

Dabrowska-Kloda K, Kloda T, Boudiaf S, Jakobsson G, Stenevi U (2015) Incidence and risk factors of late in-the-bag intraocular lens dislocation: evaluation of 140 eyes between 1992 and 2012. J Cataract Refract Surg 41(7):1376–1382. https://doi.org/10.1016/j.jcrs.2014.10.040 CrossRefPubMed

Ascaso FJ, Huerva V, Grzybowski A (2015) Epidemiology, etiology, and prevention of late IOL-capsular bag complex dislocation: review of the literature. J Ophthalmol 2015:805706. https://doi.org/10.1155/2015/805706 CrossRefPubMedPubMedCentral

Kane JX, Van Heerden A, Atik A, Petsoglou C (2016) Intraocular lens power formula accuracy: comparison of 7 formulas. J Cataract Refract Surg 42(10):1490–1500. https://doi.org/10.1016/j.jcrs.2016.07.021 CrossRefPubMed

Pueringer SL, Hodge DO, Erie JC (2011) Risk of late intraocular lens dislocation after cataract surgery, 1980-2009: a population-based study. Am J Ophthalmol 152(4):618–623. https://doi.org/10.1016/j.ajo.2011.03.009 CrossRefPubMedPubMedCentral

Davies EC, Pineda R 2nd (2016) Intraocular lens exchange surgery at a tertiary referral center: indications, complications, and visual outcomes. J Cataract Refract Surg 42(9):1262–1267. https://doi.org/10.1016/j.jcrs.2016.06.031 CrossRefPubMed

Jones JJ, Jones YJ, Jin GJ (2014) Indications and outcomes of intraocular lens exchange during a recent 5-year period. Am J Ophthalmol 157(1):154–162 e151. https://doi.org/10.1016/j.ajo.2013.08.019 CrossRefPubMed

Jehan FS, Mamalis N, Crandall AS (2001) Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Ophthalmology 108(10):1727–1731CrossRefPubMed

Mamalis N (2015) Pseudoexfoliation in intraocular lens dislocation: underdiagnosed scourge. J Cataract Refract Surg 41(5):909–910. https://doi.org/10.1016/j.jcrs.2015.05.002 CrossRefPubMed

Liu E, Cole S, Werner L, Hengerer F, Mamalis N, Kohnen T (2015) Pathologic evidence of pseudoexfoliation in cases of in-the-bag intraocular lens subluxation or dislocation. J Cataract Refract Surg 41(5):929–935. https://doi.org/10.1016/j.jcrs.2014.08.037 CrossRefPubMed

10.

Hayashi K, Hirata A, Hayashi H (2007) Possible predisposing factors for in-the-bag and out-of-the-bag intraocular lens dislocation and outcomes of intraocular lens exchange surgery. Ophthalmology 114(5):969–975. https://doi.org/10.1016/j.ophtha.2006.09.017 CrossRefPubMed

11.

Matsumoto M, Yamada K, Uematsu M, Fujikawa A, Tsuiki E, Kumagami T, Suzuma K, Kitaoka T (2012) Spontaneous dislocation of in-the-bag intraocular lens primarily in cases with prior vitrectomy. Eur J Ophthalmol 22(3):363–367. https://doi.org/10.5301/ejo.5000046 CrossRefPubMed

12.

Steeples LR, Jones NP (2015) Late in-the-bag intraocular lens dislocation in patients with uveitis. Br J Ophthalmol 99(9):1206–1210. https://doi.org/10.1136/bjophthalmol-2014-306437 CrossRefPubMed

13.

Gimbel HV, Condon GP, Kohnen T, Olson RJ, Halkiadakis I (2005) Late in-the-bag intraocular lens dislocation: incidence, prevention, and management. J Cataract Refract Surg 31(11):2193–2204. https://doi.org/10.1016/j.jcrs.2005.06.053 CrossRefPubMed

14.

Jakobsson G, Zetterberg M, Lundstrom M, Stenevi U, Grenmark R, Sundelin K (2010) Late dislocation of in-the-bag and out-of-the bag intraocular lenses: ocular and surgical characteristics and time to lens repositioning. J Cataract Refract Surg 36(10):1637–1644. https://doi.org/10.1016/j.jcrs.2010.04.042 CrossRefPubMed

15.

Fernandez-Buenaga R, Alio JL, Perez-Ardoy AL, Larrosa-Quesada A, Pinilla-Cortes L, Barraquer R, Alio JL 2nd, Munoz-Negrete FJ (2013) Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes. Eye (Lond) 27(7):795–801; quiz 802. https://doi.org/10.1038/eye.2013.95 CrossRef

16.

Brunin G, Sajjad A, Kim EJ, Montes de Oca I, Weikert MP, Wang L, Koch DD, Al-Mohtaseb Z (2017) Secondary intraocular lens implantation: complication rates, visual acuity, and refractive outcomes. J Cataract Refract Surg 43(3):369–376. https://doi.org/10.1016/j.jcrs.2016.12.024 CrossRefPubMed

17.

Mamalis N, Brubaker J, Davis D, Espandar L, Werner L (2008) Complications of foldable intraocular lenses requiring explantation or secondary intervention—2007 survey update. J Cataract Refract Surg 34(9):1584–1591. https://doi.org/10.1016/j.jcrs.2008.05.046 CrossRefPubMed

18.

Fernandez-Buenaga R, Alio JL, Pinilla-Cortes L, Barraquer RI (2013) Perioperative complications and clinical outcomes of intraocular lens exchange in patients with opacified lenses. Graefes Arch Clin Exp Ophthalmol 251(9):2141–2146. https://doi.org/10.1007/s00417-013-2411-7 CrossRefPubMed

19.

Rey A, Jurgens I, Dyrda A, Maseras X, Morilla A (2016) Surgical outcome of late in-the-bag intraocular lens dislocation treated with pars plana vitrectomy. Retina 36(3):576–581. https://doi.org/10.1097/IAE.0000000000000738 CrossRefPubMed

20.

Kristianslund O, Raen M, Ostern AE, Drolsum L (2017) Late in-the-bag intraocular lens dislocation: a randomized clinical trial comparing lens repositioning and lens exchange. Ophthalmology 124(2):151–159. https://doi.org/10.1016/j.ophtha.2016.10.024 CrossRefPubMed

21.

Dajee KP, Abbey AM, Williams GA (2016) Management of dislocated intraocular lenses in eyes with insufficient capsular support. Curr Opin Ophthalmol 27(3):191–195. https://doi.org/10.1097/ICU.0000000000000260 CrossRefPubMed

22.

Davies EC, Pineda R 2nd (2017) Complications of scleral-fixated intraocular lenses. Semin Ophthalmol 1–6. https://doi.org/10.1080/08820538.2017.1353808

23.

Guell JL, Verdaguer P, Elies D, Gris O, Manero F, Mateu-Figueras G, Morral M (2014) Secondary iris-claw anterior chamber lens implantation in patients with aphakia without capsular support. Br J Ophthalmol 98(5):658–663. https://doi.org/10.1136/bjophthalmol-2013-304035 CrossRefPubMed

24.

Karadag R, Celik HU, Bayramlar H, Rapuano CJ (2016) Sutureless Intrascleral fixated intraocular Lens implantation. J Refract Surg 32(9):586–597. https://doi.org/10.3928/1081597X-20160601-03 CrossRefPubMed

Title: Secondary intraocular lens implantation: a large retrospective analysis
Authors: Efstathios Vounotrypidis
Iris Schuster
Marc J. Mackert
Daniel Kook
Siegfried Priglinger
Armin Wolf
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 1/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-018-4178-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Secondary intraocular lens implantation: a large retrospective analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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