FEB 27, 2014
This retrospective study found that glued trans-scleral fixated posterior chamber (PC) IOL exchange for an anterior chamber (AC) IOL can be an excellent alternative in eyes with ocular complications related to AC IOLs.
The authors reviewed data from 38 eyes that underwent AC IOL explantation and replacement with a glued PC IOL.
The mean follow-up was 24.1 months (range, 8 to 60 months). The most common indications for AC IOL exchange were corneal decompensation (39.4 percent), malpositioned AC IOL (28.9 percent), uveitis (15.7 percent), glaucoma (13.1 percent) and broken haptic (2.6 percent).
CDVA and central corneal thickness improved significantly. A CDVA of better than 20/60 was obtained in 65.7 percent of eyes. Thirty-four eyes (86.8 percent) showed an improvement in CDVA after IOL exchange.
The mean endothelial cell loss was 3.4 percent. CDVA and central corneal thickness were significantly correlated (P = .000). There was a significant improvement in anterior chamber depth (P = 0.000), IOP (P = 0.005) and anterior chamber inflammation (P = 0.000) after IOL exchange. Macular edema resolved in three eyes.
These results show that IOL exchange with glued IOLs can improve clinical signs in more than 90 percent of eyes. The authors conclude that glued trans-scleral fixated IOLs are a good alternative in eyes with shallow anterior chambers or low endothelial cell counts. However, they say that a longitudinal study may be required to determine the long-term stability of these lenses.