From the Department of Ophthalmology, Antwerp University Hospital (Goemaere, Denissen, Dragnea, Tassignon, Dhubhghaill) Wilrijk, Belgium, Department of Medicine, University of Antwerp (Goemaere, Denissen, Dragnea, Tassignon, Dhubhghaill), Wilrijk, Belgium, Department of Ophthalmology, Leuven University Hospital (Trigaux, Hua), Leuven, Belgium, and Department of Medicine, Leuven University Hospital (Trigaux, Hua), Leuven, Belgium.
J Cataract Refract Surg. 2020 Dec;46(12):1596-1603. doi: 10.1097/j.jcrs.0000000000000349.
To report the indications, frequency, and outcomes regarding intraocular lens (IOL) exchange in 2 university hospital tertiary referral settings over a period of 15 years.
Ophthalmology departments of the University Hospital Antwerp and the University Hospital Leuven, Belgium.
Retrospective cross-sectional study.
In this retrospective study, included were patients who underwent an IOL exchange between 2002 and 2017. Patient demographics, surgical indication, comorbidities, visual outcomes, and complications were reported. Patients who underwent IOL repositioning or add-on IOL implantation or extraction, and patients who were left aphakic, were excluded.
Included in the study were 492 eyes. The mean age was 66.0 ± 13.3 years (range 19-91 years). The mean time between primary surgery and IOL exchange was 54.61 ± 67.07 months (range 0-343 months). Primary indication for explantation was IOL opacification, and the most common ophthalmic comorbidity was a previous history of vitreoretinal surgery. Preoperatively, the mean uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA) were 0.47 ± 0.27 (range 0-1) and 0.61 ± 0.32 (range 0-1.2), respectively. Postoperative UCVA and CDVA was 0.7 ± 0.3 (range 0-1.2) and 0.8 ± 0.28 (range 0.05-1.6), respectively. The increase in both CDVA and UCVA was statistically significant (P < .001, paired t test). The most common complication perioperatively was vitreous prolapse, which occurred in 61 eyes (16%).
IOL exchange is a challenging yet valuable treatment option for a wide spectrum of problematic IOL outcomes. The most common indication remains IOL opacification, although IOL dislocation and patient dissatisfaction are increasing as indications.
报告在比利时安特卫普大学医院和鲁汶大学医院这两所大学附属医院的三级转诊环境中，15 年来进行人工晶状体（IOL）置换的适应证、频率和结果。
在大学附属医院的三级转诊环境中，进行人工晶状体（IOL）置换的适应证、频率和结果。
安特卫普大学医院和鲁汶大学医院的眼科部门。
回顾性横断面研究。
在这项回顾性研究中，纳入了 2002 年至 2017 年间进行 IOL 置换的患者。报告了患者的人口统计学特征、手术适应证、合并症、视力结果和并发症。排除了仅行 IOL 重定位或附加 IOL 植入或取出以及遗留无晶状体眼的患者。
本研究共纳入 492 只眼。平均年龄为 66.0 ± 13.3 岁（19-91 岁）。初次手术后至 IOL 置换的平均时间为 54.61 ± 67.07 个月（0-343 个月）。IOL 摘除的主要适应证是 IOL 混浊，最常见的眼部合并症是既往玻璃体视网膜手术史。术前，未矫正视力（UCVA）和矫正距离视力（CDVA）分别为 0.47 ± 0.27（0-1）和 0.61 ± 0.32（0-1.2）。术后 UCVA 和 CDVA 分别为 0.7 ± 0.3（0-1.2）和 0.8 ± 0.28（0.05-1.6）。CDVA 和 UCVA 均有统计学显著增加（P<.001，配对 t 检验）。最常见的围手术期并发症是玻璃体脱出，发生于 61 只眼（16%）。
IOL 置换是一种具有挑战性但又有价值的治疗方法，适用于广泛的 IOL 不良结局。最常见的适应证仍然是 IOL 混浊，尽管 IOL 脱位和患者不满意的情况作为适应证在增加。
