This article is more than 5 years old. Information may no longer be current.
Understanding reasons behind IOL exchange may help with management
Click Here to Manage Email Alerts
THOROFARE, N.J. — Becoming familiar with common reasons for IOL exchange may enable surgeons to more effectively manage potential complications encountered during the exchange, according to Stephen S. Lane, MD.
IOL failure can be the result of any number of factors, including decentration and dislocation, incorrect IOL power, corneal edema, bullous keratopathy and inflammatory responses such as iritis in early undiagnosed glaucoma. The reasons for lens explantation fall into three categories: design, material or surgeon-related problems, said Dr. Lane, a professor of ophthalmology at the University of Minnesota.
Evaluating the patient before performing the explantation is important, stressed Dr. Lane, as is assessing the lens and the capsule.
“Often doctors go in and remove lenses, only to find out afterward that the patient is having the same symptoms postoperatively as they were preop,” Dr. Lane said.
Surgeons who are less experienced with lens exchange should use local rather than topical anesthetic to ensure patient comfort during the procedure, which may necessitate significant intraocular manipulations, he advised.
“As much as you can, work in a closed system under viscoelastic to position the IOL in the anterior chamber, where it can be most readily accessed,” he said. “Be sure that the IOL spins easily before attempting to prolapse it into the anterior chamber because you don't want the whole bag to come with you. Be careful not to overinflate with viscoelastic.”
More details on the specifics Dr. Lane's surgical techniques for IOL exchange can be found in the May 15 print edition of Ocular Surgery News.