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Intraocular lens exchange following refractive surprises

Session Details

Session Title: Refractive

Session Date/Time: Sunday 16/02/2014 | 08:30-11:00

Paper Time: 10:42

Venue: Kosovel Hall (Level -2)

First Author: : Arnaldo Santos PORTUGAL

Co Author(s): :    Joao Paulo Cunha   Joana Ferreira           

Abstract Details


Despite all the advances in phacoemulsification, biometry, intraocular lens (IOL) technology and IOL power calculation formulas, refractive surprises still happen in our clinical practice. The treatment options for this situation include secondary piggyback IOL implantation, IOL exchange or corneal refractive procedures. The objective of this work is to evaluate the safety, efficacy and anterior chamber morphology in eyes that had undergone IOL exchange to correct residual refractive error following cataract surgery.


Cross-sectional study conducted in the Refractive Surgery Department of Central Lisbon Hospital Center.


The authors studied twelve eyes of ten patients who had undergone IOL exchange to correct the ametropic surprise following cataract surgery. Refractive results, anterior segment optical coherence tomography (OCT), Pentacam rotating scheimpflug camera, anterior segment photography, specular microscopy and visual function evaluation using VF-14 questionnaire were performed in all patients.


The refractive results were all within ±1.0 diopter of the desired refraction. There were no significant changes in the pupil size or anterior chamber depth, angle and volume when compared with the pre-operative parameters. Central endothelial cell count was not significantly different from the pre-operative values (p > 0.05). The mean post-operative VF-14 score was 92%. There was one case retinal detachment 1 month after surgery.


IOL exchange surgery is technically demanding but when performed by an experienced surgery the complications rate is low. Refractive results were good with high levels of patient satisfaction. Anterior chamber morphology is preserved with high anterior chamber depths, angles and volumes. Central endothelial cell loss was also low and there were no cases of corneal decompensation. Thus, IOL exchange is a predictable and effective approach to manage refractive surprises following cataract surgery. FINANCIAL INTEREST: NONE