Characterising the safety and efficacy of intraocular lens exchange by surgical indication and IOL implantation sites.

PurposeTo examine the visual outcomes and complication rates for IOL (intraocular lens) exchange, analysed by combination of surgical indication and secondary IOL implantation site.DesignRetrospective case series of IOL exchange procedures performed between June 1998 and July 2018 from a single tertiary referral centre, London, United Kingdom.MethodsConsecutive IOL exchange procedures with pre-operative and 6-month post-operative visual acuity and complication data were eligible.Results318 eyes from 288 patients were included. Mean best-corrected visual acuity (BCVA) improved from 0.82 ± 0.77 to 0.47 ± 0.60 LogMAR at 6 months (p < 0.001), in particular following complete IOL dislocation (adjusted p < 0.001), partial IOL dislocation (adjusted p = 0.001), refractive indications (adjusted p = 0.02), and pseudophacodonesis (adjusted p = 0.02). The most performed and the greatest BCVA improvement was found with subsequent anterior chamber IOL implantation (-0.44 ± 0.72 LogMAR, n = 214, 67%). The poorest BCVA at 6 months was following IOL exchange for corneal oedema (1.13 ± 0.81 LogMAR, n = 16, 5%). 26% of cases underwent concurrent pars plana vitrectomy, and 15% underwent anterior vitrectomy, with 8% experiencing post-operative cystoid macular oedema.ConclusionsIOL exchange is safe and effective, however careful patient selection and pre-operative counselling assisted by such data should determine when surgery should be undertaken.