Clinical Efficacy and Complications of Intraocular Lens Exchange for Opacified Intraocular Lenses

PURPOSE: To evaluate the clinical efficacy and complications of intraocular lens (IOL) exchange. METHODS: A review of medical records was performed for 52 eyes that had undergone an IOL exchange due to IOL opacification. Surgical complications and their incidences were analyzed. The mean best corrected visual acuity (BCVA) after the IOL exchange was compared with the mean pre-exchange BCVA and with the mean BCVA after the initial IOL implantation. Prediction error of refraction and biometric data obtained for the IOL exchange were, if available, compared with those obtained for the initial IOL implantation. The prediction error for the IOL exchange, calculated from the biometric data obtained before the IOL exchange, was compared with that calculated from the measurements obtained before the initial IOL implantation. RESULTS: The overall complication rates were low and no serious complications were found. The mean BCVA improved significantly after the IOL exchange and was not significantly different from that obtained after the initial IOL implantation. However, the refractive prediction for the IOL exchange was not as good as it was for the initial IOL implantation, which was thought to be related with difficulties in axial length (AL) measurements. Biometric data taken before the initial IOL implantation was associated with a significantly better refractive prediction than those taken before the IOL exchange. CONCLUSIONS: IOL exchange was both efficacious and safe for visual recovery. However, IOL exchange was related with increased difficulty of predicting postoperative refraction; difficulties in AL measurements are the suggested cause.