Secondary intraocular lens interventions: predisposing factors, indications and coincident procedures

Abstract

To evaluate the predisposing factors, indications and coincident procedures in patients requiring a secondary intraocular lens (IOL)-related intervention. We reviewed data on 183 consecutive secondary IOL-related procedures. Information collected included demographics, predisposing factors, IOL status, indication for surgery, coincident procedures, and final IOL location and fixation method. Of the 183 procedures performed, 73 were secondary IOL implantations, 68 were IOL exchanges and 42 were IOL repositionings. Predisposing factors were found in 88.6 % of the cases, the most common being complicated cataract surgery (39.8 %) followed by trauma (20.2 %). The most common indications for surgery in the anterior chamber IOL and posterior chamber IOL groups were pseudophakic bullous keratopathy ± failed graft (77.2 %) and subluxated IOL (57.53 %), respectively. A malpositioned or subluxated lens was found in 47.86 % of all pseudophakic eyes. A simultaneous procedure was performed in 67 % of cases, anterior vitrectomy being the most common (43.7 %), followed by keratoplasty (35 %). Secondary IOL-related interventions were associated with predisposing factors, complicated cataract surgery being the most common. Patients implanted with anterior chamber IOLs seemed to have a more complicated course requiring more complex secondary surgeries and associated procedures.