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Dislocation, decentration leading cause of IOL explantation in Spain
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The leading cause of IOL explantation was dislocation or decentration, followed by incorrect lens power and IOL opacification, according to a study conducted in Spain.
“Intraocular lens explantation is infrequent, but potentially may be associated with serious complications. Explantation, when it happens, should be considered as one of the most important failures of modern cataract surgery,” the study authors said. “The reasons for explantation are diverse and related to multiple factors, including intraocular comorbidities. In any case, IOL explantation sometimes occurs after an uneventful cataract surgery.”
The retrospective, multicenter study analyzed 257 pseudophakic IOLs that were explanted between 2004 and 2010. Extracapsular cataract extraction was the primary procedure in all cases. Surgical protocols and explantation techniques varied according to surgeon and center.
Patients had a mean age of 67.5 years at the time of explantation. The mean interval between implantation and explantation was 3.97 years.
Study results showed that explantation was attributed to dislocation or decentration in 56.3% of cases, incorrect lens power in 12.8%, IOL opacification in 11.3%, neuroadaptation failure in 6.2%, pseudophakic bullous keratopathy in 2.3%, endophthalmitis in 1.9%, and other causes in 8.9%.
The five most commonly explanted IOLs were Alcon AcrySof MA60BM (10.9%), Alcon AcrySof SA60AT (9.7%), Bausch + Lomb Hydroview (7.8%), Carl Zeiss Meditec Acri.Lisa (3.5%) and Alcon AcrySof ReSTOR (2.7%).
Subsequent treatment after explantation included posterior chamber implantation in 149 eyes (58%), anterior chamber implantation in 49 eyes (19.1%) and aphakia in 39 eyes (15.2%). Treatment information was unavailable for 20 eyes.
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