Intraocular Lens Exchange: Indications, Outcomes, And Complications

This study aims to evaluate the indications, clinical and visual outcomes, and complications associated with intraocular lens (IOL) exchange procedures performed over the past decade at a tertiary ophthalmology center.

Beyoglu Eye Training and Research Hospital

A retrospective analysis was conducted on cases that underwent IOL exchange between 2014 and 2024. Patient demographics, surgical indications, methods of IOL implantation, and postoperative complications were assessed. Preoperative and final follow-up uncorrected and corrected distance visual acuity (CDVA) were analyzed to evaluate visual outcomes.

A total 151 eyes from 151patient were included, with a mean age of 66.5±14.9 years.The mean followup duration was 20.2±23.2 months, and the interval between primary IOL implantation and exchange averaged 90.1±91.2 months. Pseudoexfoliation was in 39.1% of cases,12.6% had trauma history. The main indication was IOL subluxation 69.5%, followed by corneal decompensation 11.9%, incorrect diopter 9.3%, opacification 7.9% damaged IOL 0.7% and IOL-related uveitis 0.7%. Postoperative IOL placement included scleral fixation Z sutures 47%,Yamane technique 17.2%, sulcus (14.6%) and in-the-bag 8.6%; aphakia occurred in 12.6%. Complications included glaucoma 10.6% and endothelial decompensation 10%. CDVA improved from 1.19±0.9 to 0.76±0.9 logMAR p<0.001

IOL exchange represents an effective surgical option for addressing various complications related to malpositioned or dysfunctional IOLs, with IOL subluxation being the most common indication. While significant improvements in visual acuity were observed, the surgery is associated with notable risks, including corneal and retinal complications. Therefore, careful patient selection and meticulous surgical techniques are essential to optimize outcomes and minimize complications.