Dislocation and decentration most common reasons for IOL explantation

Dislocation and decentration are the most common reasons for intraocular lens explantation, with endothelial decompensation the next most important factor, reported Mohamed El Sanharawi MD, PhD at the at the French Implant and Refractive Surgery Association (SAFIR) annual meeting in Paris.

Dr Sanharawi presented the results of a retrospective study of all causes of explantation over a 10-year period between 2005 and 2014 at the Quinze-Vingts University Hospital in Paris.

Of a total of 927 explantations, decentration and dislocation was the cause in 554 cases (60%), followed by endothelial decompensation in 182 (20%) cases. Phakic implants that had to be removed because of cataract or sizing issues occurred in 59 cases (6%), with other issues such as IOL power calculation errors (5%), opacfication (4%), badly-tolerated multifocal IOLs (3%) and endophthalmitis (2%) accounting for the remainder of the explantations.

Dr Sanharawi noted that the explantation rate because of lens dislocation has remained stable over the 10-year follow-up period, while calculation errors have shown a discernable decrease thanks to improved biometry and preoperative diagnostics. Reimplantation remains the favoured solution to deal with explantations in 80% to 90% of cases, he concluded.