Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, 23 Paidar Fard, Bostan 9, Pasdaran Ave, Tehran, 16666, Iran.
BMC Ophthalmol. 2023 Mar 28;23(1):127. doi: 10.1186/s12886-023-02871-y.
To determine the indications and surgical outcomes of intraocular lens (IOL) exchange in pseudophakic patients at Labbafinejad Tertiary Referral Center between 2014 and 2019.
In this retrospective interventional case series, the medical records of 193 patients with a history of IOL exchange were reviewed. Preoperative data, including clinical characteristics, indications of the first and second IOL implantation, intra- and postoperative complications due to IOL exchange, and the pre-and postoperative refractive error and best-corrected visual acuity (BCVA) were considered the outcome measures in this study. All postoperative data were analyzed at least six months after follow-up.
The mean age of our participants was 59.13 ± 20.97 years old at the time of the IOL exchange, with a male percentage of 63.2%. The mean follow-up after the IOL exchange was 15.72 ± 16.28 months. The main indications of IOL exchange were IOL decentration (50.3%), corneal decompensation (30.6%), and residual refractive errors (8.3%). 57.10% of patients with the postoperative spherical equivalent at -2.00 diopter (D) to + 2.00D. The mean best-corrected visual acuity was 0.82 ± 0.76 LogMAR before the IOL exchange and was improved to 0.73 ± 0.79 LogMAR after the surgery. Corneal decompensation (6.2%), glaucoma (4.7%), retinal detachment (4.1%), cystoid macular edema (2.1%), and uveitis (1%) were found as the postoperative complications. There was only one case with suprachoroidal hemorrhage during IOL exchange.
IOL decentration followed by corneal decompensation was the most common indication of IOL exchange. After IOL exchange, the most complications during follow-up were corneal decompensation, glaucoma, retinal detachment, and cystoid macular edema.
在 2014 年至 2019 年期间，在拉巴菲纳德三级转诊中心确定假晶状体患者的人工晶状体（IOL）置换的适应证和手术结果。
在这项回顾性干预性病例系列研究中，回顾了 193 名有 IOL 置换史的患者的病历。术前数据包括临床特征、第一次和第二次 IOL 植入的适应证、IOL 置换引起的围手术期并发症以及术前和术后屈光不正和最佳矫正视力（BCVA），这些都是本研究的结果衡量标准。所有术后数据均在随访至少 6 个月后进行分析。
我们参与者的平均年龄为 59.13±20.97 岁，男性占 63.2%。IOL 置换后的平均随访时间为 15.72±16.28 个月。IOL 置换的主要适应证为 IOL 偏心（50.3%）、角膜失代偿（30.6%）和残余屈光不正（8.3%）。57.10%的患者术后等效球镜值在-2.00 屈光度（D）至+2.00D 之间。IOL 置换前平均最佳矫正视力为 0.82±0.76 LogMAR，术后改善至 0.73±0.79 LogMAR。术后发现角膜失代偿（6.2%）、青光眼（4.7%）、视网膜脱离（4.1%）、囊样黄斑水肿（2.1%）和葡萄膜炎（1%）等并发症。在 IOL 置换过程中只有一例发生脉络膜上腔出血。
IOL 偏心继发于角膜失代偿是 IOL 置换最常见的适应证。IOL 置换后，随访期间最常见的并发症是角膜失代偿、青光眼、视网膜脱离和囊样黄斑水肿。
