Objective: To explore the causes, surgical principle and effect of lens exchange surgery.
Methods: The causes for 30 cases (30 eyes) of lens exchange were retrospectively analyzed, which included 11 cases with eccentric or dislocated intraocular lens (IOL, 36.7%), 8 cases with lens opacification (26.7%), 8 cases with incorrect power (26.7%) and 3 cases with iris capture (10.0%). There were 16 males and 14 females aged 32 to 80 years (average, 62).
Results: After extraction of the original implant, the second IOL was inserted in the lens bag in 11 cases (36.7%), in the ciliary sulcus in 13 cases (43.3%), in the anterior chamber in 1 case (3.3%) and with scleral fixation in 5 cases (16.7%). In the follow-up of 1 - 24 months, the best corrected visual acuity over 0.5 was achieved in 23 cases (76.7%), 0.3 - 0.4 in 5 cases (16.7%), under 0.2 in 2 cases (6.6%). The surgical complications included astigmatism in 4 cases, cystoid macular edema 1 case, hyphema 1 case and posterior capsular opacification 1 case.
Conclusions: The eccentric or dislocated IOL, lens opacification and incorrect power are the major causes of lens exchange. Proper IOL selected and meticulous operative technique can avoid the abnormality of IOL, and the lens exchange is an effective way to manage the situation.