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Dislocation/decentration continues to be concern with foldable IOLs


Dislocation/decentration continues to be one of the most common concerns associated with foldable IOLs requiring explantation, followed by glare/optical aberrations and incorrect lens power, according the results of the ninth annual ASCRS/ESCRS foldable IOL survey.

Key Points

The survey found that IOL dislocation and decentration again topped the list as the most frequently occurring complication requiring explantation of one-piece acrylic lenses with haptics, three-piece acrylic lenses, three-piece silicone lenses, and one-piece (plate) silicone lenses.

The most common complication for the three-piece hydrogel lens was calcification/ opacification, followed by dislocation and decentration. For multifocal acrylic lenses, the most common reason for explantation was glare/optical aberrations, followed by dislocation and decentration and incorrect lens power, reported Nick Mamalis, MD, at the ASCRS annual meeting. He is director of the Intermountain Ocular Research Center and professor, Moran Eye Center, Department of Ophthalmology, University of Utah, Salt Lake City.

"When we review the survey lens totals, we want to see what complications are causing a particular lens to be removed. We are not looking to see which lenses were removed the most," Dr. Mamalis emphasized.

In the case of the three-piece hydrogel lens, dislocation and decentration were not as problematic as calcification/opacification. "Calcification of hydrophilic acrylic lenses still remains a problem, which is seen in one-piece and three-piece lenses," he said. "This is a worldwide phenomenon."

Patients with multifocal lenses that must be removed cite glare and optical aberrations, followed by dislocation and decentration as well as incorrect lens power as the most common reasons. "So this is different from what we are seeing in the other lenses," Dr. Mamalis noted.

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