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Dislocation, decentration most common reasons for foldable IOL explantation
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LONDON — Dislocation and decentration remain the most common reasons for explantation of foldable IOLs, according to survey data presented here. The finding highlights the need for good surgical techniques, one of the investigators said.
The survey, which was conducted jointly by the European Society of Cataract and Refractive Surgeons (ESCRS) and the American Society of Cataract and Refractive Surgery (ASCRS), analyzed reasons for foldable IOL explantation or secondary intervention. The survey was given to all ESCRS and ASCRS members through 2005.
Specifically, the survey addressed 1-piece plate IOLs, 1-piece IOLs with haptics, 3-piece IOLs and multifocal IOLs manufactured using hydrophilic acrylic, hydrophobic acrylic or silicone polymers.
Nick Mamalis, MD, of the Moran Eye Center in the United States, discussed the results at the ESCRS annual meeting.
The most common problems reported included glare or optical aberrations. Incorrect lens power followed dislocation and decentration, Dr. Mamalis said.
However, dislocation and decentration were reported as the most common problems with 3-piece silicone IOLs and 1-piece plate silicone IOLs. In contrast, incorrect lens power was the main problem with 3-piece acrylic lenses and 1-piece lenses with haptics, he said.
For the first time, calcification and opacification were reported in the survey with 3-piece hydrogel IOLs. But, "this was seen exclusively with hydrogel or hydrophilic acrylic IOLs," he said, noting that these problems appeared in hydrophilic acrylics 2 to 3 years after they were approved for surgical use.
Dr. Mamalis noted that good surgical technique and accurate IOL measurements can help surgeons avoid such problems. New formulas and measurements for axial length are also needed, he said.