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Dislocation, decentration top list of foldable IOL complications

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LOS ANGELES — Dislocation and decentration continue to be the most common reason to explant a foldable IOL, according to a yearly survey presented at the American Society of Cataract and Refractive Surgery meeting.

The survey, which looks at rates of and reasons for explantation or secondary intervention for foldable IOLs, was available in 2016 to members of the ASCRS and the European Society of Cataract and Refractive Surgeons.

Nick Mamalis

“There are some lenses we’ve looked at over the entire 18 years of the survey,” Nick Mamalis, MD, said. “In the three-piece silicon lenses, ... dislocation/decentration has always been the highest, and still is. Three-piece acrylic is the same—dislocation/decentration over the years. One-piece silicon is almost all dislocation/decentration.”

Following decentration/dislocation, the most common complications for foldable IOLs were incorrect lens power, glare/optical aberrations and calcifications.

This year, the survey showed an increasing number of explanted multifocal IOLs, while hydrophilic acrylic and plate haptic silicone IOLs were explanted less often. Hinged plate silicon accommodating IOLs appeared on the survey as well, but their numbers were too few to make any conclusions, according to Mamalis.

To avoid complications, good surgical technique is essential, Mamalis said.

“You have to have an intact capsulorrhexis and you have to put the implant in the bag. You need accurate IOL measurements and proper patient selection in multifocal lenses so you don’t run into issues of people being unhappy with the quality of their vision,” Mamalis said. – by Robert Linnehan

Reference:

Mamalis N. ASCRS/ESCRS survey on foldable IOLs requiring explanation or secondary intervention: 2016 update. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 5-9, 2017; Los Angeles.

Disclosure: Mamalis reports no relevant financial disclosures.