Pattern and Clinical Outcome of Secondary Intraocular Lens Implantations in Tertiary Hospital Setting

Abstract

Background:
Secondary intraocular lens implantation (IOL) is an insertion of a lens in any eye that was left aphakic by trauma or previous surgery. Objectives: To analyze the pattern, indications, visual outcome and complications of secondary IOL implantation in a tertiary hospital setting.
Materials and methods:
A retrospective study was done at Ibn Al-Haitham Teaching Eye Hospital. Review of medical records for patients who underwent secondary IOL implantation from October 2014 to December 2016 was done. Data collected included indication, type of surgical procedure, intraocular lens type used, corrected-distance visual acuity (CDVA) before and after surgical procedure and complications encountered.
Results:
Thirty-seven patients were included in this study. Males comprised 64.86%. Indications included post-congenital cataract or traumatic cataract surgery, and post cataract surgery who were left aphakic. Posterior chamber (PC) IOL implant in sulcus was used in 54.05%, 18.92% underwent anterior chamber (AC) IOL, 13.51% underwent scleral-fixation IOL and 13.51% underwent iris clipped IOL. Regarding the visual acuity, it was found that there is an improvement of 2.25 lines in CDVA post-secondary IOL implantation by using PC IOL implant in sulcus, 1.71lines in CDVA by using AC IOL, 1.2 lines in CDVA by using iris clipped IOL and only 0.6 line in CDVA by using scleral fixative IOL. Three cases (8.11%) eyes had corneal decompensation in addition to three cases (8.11%) eyes had subluxated IOL, regardless of the method of IOL implantation.
Conclusion:
There was no significant difference in visual acuity outcomes between different modalities of secondary IOL implantation. The rate of complications was not different. The main determinant of surgical choice was presence of capsular support.