This article is more than 5 years old. Information may no longer be current.
Survey: Surgeon error still a leading cause of foldable IOL explantation
Click Here to Manage Email Alerts
SAN DIEGO, Calif. — Surgeon mistakes, including improper IOL power calculations, are the leading causes mandating explantation of foldable IOLs, regardless of lens material, said Nick Mamalis, MD, in a presentation here.
Dr. Mamalis reported on the annual joint survey of members of the American Society of Cataract and Refractive Surgery and the European Society of Cataract and Refractive Surgeons here at the ASCRS meeting.
“The complications vary depending upon the type of foldable IOL used,” Dr. Mamalis said. “Some complications are particular to a particular type of lens material.”
Incorrect lens power, glare or visual aberrations, and dislocation or decentration were the most common reasons for removal of three-piece silicone IOLs, three-piece acrylic IOLs and one-piece acrylic IOLs, he said.
For one-piece silicone IOLs, dislocation and decentration were the most common reasons for explantation, Dr. Mamalis said. Hydrophilic acrylic IOLs were most commonly removed due to postoperative calcification.
Multifocal silicone IOLs were most often explanted because of glare or optical aberrations, he said.
Postoperatively, however, good visual results were obtained in all patients, Dr. Mamalis noted.
Excellent surgical technique is mandatory to lower the explantation rate, he stressed.
“The most common reason for removing these lenses is us,” he said. “Surgeons need to have good loading technique, good insertion technique, accurate IOL measurements and proper patient selection.”
While some surgical error rates such as decentration have decreased in the 6 years since the survey was first done, “we haven’t seen any decrease in the rate of IOL power miscalculations,” Dr. Mamalis said.