Clinical Outcomes of Secondary Intraocular Lens Implantation in Vitrectomized Aphakic Eyes Due to Ocular Trauma

Sung I1 Kim; Ik Soo Byon; Ji Eun Lee

doi:10.3341/jkos.2013.54.10.1581

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Kim, Byon, and Lee: Clinical Outcomes of Secondary Intraocular Lens Implantation in Vitrectomized Aphakic Eyes Due to Ocular Trauma

Original Article

J Korean Ophthalmol Soc 2013;54(10):1581-1587.

Published online: 3 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.10.1581

Clinical Outcomes of Secondary Intraocular Lens Implantation in Vitrectomized Aphakic Eyes Due to Ocular Trauma

Sung I1 Kim, MD¹, Ik Soo Byon, MD², Ji Eun Lee, MD, PhD¹

¹Department of Ophthalmology, Pusan National University School of Medicine, Busan, Korea

²Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea

Address reprint requests to Ji Eun Lee, MD, PhD, Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 602-739, Korea, Tel: 82-51-240-7326, Fax: 82-51-242-7341, E-mail: jlee@pusan.ac.kr

Received 4 March 2013 Revised 2 June 2013 Accepted 24 August 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical outcomes of secondary intraocular lens (IOL) implantation in eyes that underwent pars plana vitrectomy and lens removal due to ocular trauma.

Methods

We retrospectively investigated 40 vitrectomized aphakic eyes that had received secondary IOL from March 2005 to January 2012. Various parameters including pre- and postoperative best corrected visual acuity (BCVA) were reviewed.

Results

Incidence was higher in males (n = 35, 89.7%) and highest in the 6th decade of life (n = 13, 33.3%). Mean preoperative refractive error was +9.99 ± 2.80 D in spherical equivalent, and astigmatism was 1.80 ± 1.73 D. Mean BCVA (log MAR) was 0.53 ± 0.51 preoperatively and 0.54 ± 0.46 at 6 months postoperatively. Postoperative refractive error was −1.28 ± 1.40 D and the astigmatism was 2.54 ± 1.52 D. The difference between the target and postoperative refractive error was a myopic shift of −0.63 ± 1.44 D. Postoperative BCVA had no significant correlation with preoperative factors other than preoperative BCVA (p < 0.001). The most common complication was temporarily increased IOP in 4 eyes. Choroidal detachment, recurrence of retinal detachment, bullous keratopathy, and cystoid macular edema were each found in 1 eye. IOL dislocation was corrected with reoperation in 2 eyes.

Conclusions

Secondary IOL implantation can be performed safely in vitrectomized aphakic eyes due to ocular trauma and can be recommended in patients with good preoperative BCVA. Myopic shift of the postoperative refractive error should be considered when calculating IOL power.

Keywords: Aphakia, Secondary IOL implantation, Trauma, Vitrectomy

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Figure 1.

Preoperative and postoperative visual acuity had significant correlation (r = 0.687,p < 0.001) after secondary intraocular lens implantation in vitrectomized aphakic eye due to trauma (*best corrected visual acuity).

Table 1.

Baseline characteristics

Parameter	Number
Laterality (right : left)	22 : 18
Sex (male : female)	35 : 4
Age (years)	48.8 ± 14.4
Laceration site
Cornea	21 eyes (52.5%)
Sclera	5 eyes (12.5%)
Corneosclera	4 eyes (10.0%)
None	10 eyes (25.0%)
Retinal detachment	13 eyes (32.5%)
IOFB	13 eyes (32.5%)
Additional procedure in primary operation
Encircling + SO injection	9 eyes (22.5%)
SO injection only	4 eyes (32.5%)
Gas injection only	9 eyes (22.5%)
Best-corrected visual acuity (log MAR)	0.53 ± 0.51
Spherical equivalent	+9.99 ± 2.80D
Target refractive error	−0.65 ± 0.40D

Values are presented as mean ± SD.

IOFB = intraocular foreign body; SO = silicone oil.

Table 2.

Changes of visual acuity, refractive error, and astigmatism after secondary intraocular lens implantation in vitrectomized aphakic eye due to trauma

Parameter	Preoperative	1 month	3 months	6 months
Best corrected visual acuity (log MAR)	0.53 ± 0.51	0.71 ± 0.49	0.60 ± 0.48	0.54 ± 0.46
	(0.0∼2.0)	(0.0 ∼ 2.0)	(0.0 ∼ 2.0)	(0.0 ∼ 2.0)
Spherical equivalent (diopter)	+9.99 ± 2.80	−1.46 ± 1.63	−1.35 ± 1.51	−1.28 ± 1.40
	(+3.38∼+14.00)	(-7.00∼+1.38)	(-6.88∼+1.00)	(-6.00∼+1.13)
Astigmatism (diopter)	1.80 ± 1.73	2.46 ± 1.80	2.31 ± 1.40	2.54 ± 1.52
	(0.00 ∼ 6.25)	(0.25 ∼ 6.50)	(0.50 ∼ 5.25)	(0.00 ∼5.25)

Values are presented as mean ± SD and range.

log MAR = logarithm of mininal angle resolution.

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