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    Dislocation main reason for IOL explantations, survey finds

     

    Lens type results

    In the one-piece plate silicone lenses, which are the original silicone lenses, the most common reason for explantation is dislocation/decentration. There was also some calcification of these lenses in the setting of asteroid hyalosis, especially in patients who have had a YAG laser posterior capsulotomy.

    For the three-piece silicone lenses, the most common reason again is dislocation/decentration. Some of these silicone lenses are also calcifying, as  described above, Dr. Mamalis added.

    In the one-piece with haptics hydrophobic acrylic lenses, dislocation/decentration is most common, but incorrect lens power is also present. Despite attempts to make better IOL calculations with the latest technology to decrease the incidence of incorrect lens power, dislocation/decentration still was common in the surveys.Courtesy of Nick Mamalis, MD

    In three-piece, hydrophobic acrylic lenses, again dislocation/decentration is most common. This is obviously a common thread in a lot of these lenses. In this particular group, some also showed signs of irritation, iritis, and inflammation.

    The one-piece with haptics hydrophilic lens (hydrogel) is different. In this group the most common reason for removal is calcification. This is a different type of calcification from the silicone calcification, which is secondary. These lenses are primarily calcifying, either on or under the surface.

    Dr. Mamalis pointed out that glare and visual aberrations in the multifocal lenses were the most common reasons for lens removal. This is different from the complications causing explantation of the other types of lenses.

    However, not much difference was found between toric lenses and similar lenses–again, dislocation/decentration. Incorrect lens power also was one of the common reasons why these lenses were explanted.

    Reasons for problems

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