Exclusively refractive intraocular lens exchange
Year: 2026
Type: article
Abstract: Purpose. To evaluate the main reasons, clinical effectiveness, and safety of exclusively refractive intraocular lens (IOL) exchange in a series of clinical cases involving patients after uncomplicated phacoemulsification. Material and methods. Fourteen patients (4 men and 10 women) aged 41 to 61 years with previously correctly implanted IOLs following uncomplicated phacoemulsification for cataracts (12 eyes) or refractive lens replacement (2 eyes), with no postoperative complications or associated intraocular pathologies, underwent IOL exchange exclusively for refractive purposes 2 to 9 months after the initial procedure. Results. The most common reason for refractive IOL exchange was uncompensated or incompletely compensated corneal astigmatism with oblique or againstthe-rule axes. The second most common reason was the patient’s desire to eliminate spectacle correction for intermediate and near distances. The third and fourth reasons were prominent positive dysphotopsia with blurred vision and significant residual ametropia following primary IOL implantation. All treated patients were satisfied with the clinical outcomes, and the postoperative period was uneventful. By postoperative days 1–3, statistically significant improvements in uncorrected visual acuity from 0.28 (0.20) to 0.81 (0.34) and best-corrected visual acuity from 0.73 (0.10) to 0.90 (0.19) were recorded. Postoperative visometry on days 1–3 demonstrated statistically significant (p<0.05) corneal astigmatism correction from 1.5 (0.75) D to 0.25 (0.2) D. Analysis of spherical equivalent changes one month after IOL exchange revealed significant (p=0.05) reduction from –0.5 (1.25) to –0.2 (0.5) D in all patients. Conclusion. Refractive IOL exchange can be a procedure of choice for patients dissatisfied with the functional outcomes of primary uncomplicated IOL implantation and seeking improved visual quality, including through the use of modern IOL models. Advanced surgical equipment and high-level surgeon expertise enable refractive IOL exchange to be considered an alternative method for correcting ametropia after lens surgery. Keywords: pseudophakia, intraocular lens (IOL) exchange, refractive IOL exchange, IOL reimplantation, astigmatism
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204991323