Foldable IOLs: dislocation most common explant cause

Dislocation and decentration are, overall, the most common reasons for foldable intraocular lens (IOL) explantation, and the incidence of these complications is rising, said Nick Mamalis, MD of the John Moran Centre, University of Utah, USA. Other major causes for explantation are glare and optical aberrations, incorrect lens power and calcification of hydrophilic (hydrogel) IOLs, according to Dr Mammalis.

These are the latest results of the ASCRS/ESCRS survey on foldable IOLs requiring explantation or secondary intervention. This annual survey is now in its ninth year.

"The most common complications involving foldable IOLs have changed very little over the last three years and may continue to be avoided by excellent surgical technique, quality manufacturing, careful IOL folding and insertion, and accurate IOL measurements," Dr Mamalis noted.

The survey comes from questionnaires filled out by contributing surgeons each time they explant a foldable IOL. It discovered that complications vary according to the type of foldable IOL. Dislocation and decentration was the most common complication associated with one-piece silicone IOLs.

Similarly, dislocation/decentration was the most common cause of explantation for three piece silicone, three-piece acrylic and one-piece acrylic IOLs, followed by glare and other optical aberrations. Calcification or opacification was the most common cause of hydrophilic acrylic IOL explantation.

Over the nine years of the survey, the incidence of dislocation decentration has increased.

Dr Mamalis concluded with a plea to surgeons to complete the questionnaire whenever they explant a foldable IOL. The survey is available on the ASCRS website.