Analysis Of Outcomes Following Explantation Of Intraocular Lenses With Primary Opacification At Donostia University Hospital During The Period 2019-2023.

To describe and analyze outcomes in a cohort of patients with primary opacification of the intraocular lens requiring surgical explantation.

26 eyes (13 right and 13 left) of patients with intraocular lens opacification models L313 and L302-1 by Oculentis (Topcon Healthcare) requiring explantation at Donostia University Hospital between January 1, 2019, and December 31, 2023, were studied.

A descriptive, observational, retrospective single-center study was conducted. The study was approved by the Research Ethics Committee of Donostia University Hospital. Patients were identified using the Corporate Identification Code (CIC) assigned by the Basque Health Service-Osakidetza to maintain confidentiality. Data on pre and postoperative examination, time intervals between initial cataract surgery and diagnosis of IOL opacification and subsequent explantation surgery, and postoperative complications were collected. These data were gathered through the Osakidetza-Basque Health Service electronic medical records system (Osabide global). Statistical analysis was conducted using the SPSS software.

The mean time from phacoemulsification surgery to diagnosis of opacification was 8.04 years, and 9.36 years from cataract surgery to lens explantation. Pre-explant visual acuity (VA) was 0.26 (logMAR), post-explant VA was 0.25 (logMAR) (p=0.4). 14 of 26 eyes had prior YAG capsulotomy. Among 26 explanted lenses, 12 were L313 and 14 were L302-1 models by Oculentis (Topcon Healthcare). 16 eyes required vitrectomy during explantation surgery, with 10 having prior YAG capsulotomy (p=0.034). Of these 16 eyes, 6 were L313 and 10 were L302-1 (p=0.422). There were 10 cases with secondary complications, 7 of them required vitrectomy during explantation surgery (p=0.68) and 4 corresponded to L313 lenses (p=0.701).

VA post-lens exchange did not show significant improvement despite subjective patient perception of improvement. Preoperative YAG capsulotomy may predispose to increased need for vitrectomy during lens explantation surgery and more complex surgeries, although not significantly associated with increased postoperative complications. No statistically significant association was observed between the design of explanted lenses and surgical procedure or postoperative complications.