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Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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The efficacy of intraocular lens exchanges

Poster Details

First Author: L.van Vught THE NETHERLANDS

Co Author(s):    Z. Gaurisankar   Y. Cheng   J. Beenakker   G. Luyten           

Abstract Details


In general, pseudophakic intraocular lenses (IOLs) provide both a satisfying visual acuity and quality of vision. However, some patients suffer from IOL-related visual complaints, such as dysphotopsia and under- or overcorrections, or from IOL (sub)luxation and decentration. For these indications, one can perform an IOL exchange, where the IOL is explanted and replaced by another IOL type, in order to resolve the complaints. To provide more insight into the effectivity and safety of this operation, all IOL-exchanges performed in our clinic over the last 4 years have been analysed retrospectively.


Department of Ophthalmology, Leiden University Medical Center (LUMC), Leiden, the The Netherlands.


In the LUMC, the IOL-exchanges are performed by luxating the superior haptic of the implanted IOL into the anterior eye chamber, after which the IOL is extracted from the eye through a 5.0 mm corneoscleral incision. After extraction, a new IOL is implanted in the capsular bag or, in cases with prior YAG-laser after cataract dissection, in the sulcus with lens capture. Subsequently, the corneal wound is closed using a double cross-stitch suture. A retrospective analysis of 89 IOL-exchanges has been performed in terms of indication, effect of the operation, complication risks and resultant visual acuity (VA) and refractive error.


A total of 89 operations were analysed. The majority of the exchanges were performed for complaints of dysphotopsia (39%), (sub)luxation or decentration (25%) or complaints of multifocal IOLs (21%). Exchanging the IOL had a positive effect on the primary complaint in 76% of the patients. Intra-operative complaints were seen in 1/89 operations. Postoperatively, cystoid macular edema was seen in 2/89 patients and retinal detachment in 1/89. Average VA and refractive error were comparable before (VA (Snellen): 0.90, S: +0.44 Diopter, C: -1.08 Diopter) and one month after surgery (VA (Snellen): 0.96, S: -0.23 Diopter, C: -1.66 Diopter).


In 76% of the cases, exchanging the IOL has a positive effect on the primary complaint, with a low risk of complications. Furthermore, the average VA and refractive error are comparable before and after the exchange. In conclusion, exchanging the IOL, when performed with the described technique, is an effective and safe treatment for a variety of IOL-related visual complaints.

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