Primary calcification of hydrophilic acrylic lenses in a large population: incidence and outcomes of lens exchange procedures.

PURPOSE: To assess the incidence of primary opacification and analyze the outcomes of intraocular lens (IOL) exchange procedures.

SETTING

Private clinics, United Kingdom.

DESIGN

Retrospective study.

METHODS

Electronic charts of all patients implanted with LENTIS lenses between 2010 and 2015 were reviewed, and the incidence of opacification was calculated. The data of patients who developed opacification were compared with those who did not. In eyes requiring IOL exchange due to opacification, visual and refractive outcomes of the last available postexchange visit were analyzed. The analysis was performed separately for eyes with multifocal and monofocal secondary IOLs.

RESULTS

47 171 LENTIS IOLs were implanted of which 2426 (5.1%) opacified. Of the opacified lenses, 1568 (3.3% of the whole cohort) required an IOL exchange. The mean time from primary treatment to opacification diagnosis was 6.9 ± 2.2 years. Patients who developed opacification had a higher prevalence of preoperative myopia. Of all eyes requiring an IOL exchange, the secondary IOL was monofocal in 43.0% and multifocal in 57.0% of eyes. Postexchange corrected visual acuity was 0.00 ± 0.13 logMAR (20/20) in eyes with monofocal secondary IOLs and -0.02 ± 0.08 logMAR (20/20 +1 ) in eyes with multifocal secondary IOLs. The final anatomical position of the secondary IOL was as follows: in-the-bag fixation 67.9%, ciliary sulcus fixation 30.1%, iris-claw fixation 0.6%, and iris suturing or scleral fixation 1.4%.

CONCLUSIONS

Exchange of opacified IOL was performed safely in most of the patients who developed opacification, including those with prior Nd:YAG capsulotomy, with good visual and refractive outcomes.