Title: IOL exchange
Author (s): Russell Swan, MD; Bala Ambati, MD
Keywords/Main Subjects: IOL exchange; Dysphotopsia; Multifocal IOL; Monofocal IOL; Cataract surgery
Diagnosis: Dysphotopsia; Multifocal IOL
Description: This 72 year old male presented to the ophthalmology clinic with complaints of glare, haloes, and progressive decrease vision. He had previously undergone cataract surgery with placement of multifocal lenses in both eyes at an outside institution. On exam eh was noted to have 20/30 vision with a well cenetered multifocal IOL and posterior capsule obstruction. After discussion of the risks benefits and alternatives to IOL exchange versus YAG capsulotomy the patient elected to proceed with IOL exchange with placement of a monofocal IOL. He tolerated the procedure well and was 20/20 post-operative day one with polishing of his posterior capsule intraopertively.
In the largest published American study of IOL exchange1, the most common indications for IOL exchange were as follows: IOL dislocation (46%), incorrect IOL power (23%), patient dissatisfaction (21%), and optic opacification (7Of the dissatisfied patients, 42% (5/11) had undesired visual acuity without symptoms of glare/optical aberrations. Overall in there series of 59 eyes, the mean logMAR BCVA improved significantly (P < .001) and 88% of all eyes were 20/40 or better, including 73% in the IOL dislocation group and 100% in all other groups. No vision-threatening complications occurred in this series.
- Jones, J. et al. Indications and outcomes of intraocular lens exchange during a recent 5-year period. Am J Ophthalmol. 2014 Jan;157(1):154-162
Faculty Approval by: Bala Ambati, MD