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99 EW RESIDENTS September 2016 cases. J Cataract Refract Surg. 2010;36: 1270–82. 5. Galor A, et al. Intraocular lens exchange surgery in dissatisfied patients with refractive intraocular lenses. J Cataract Refract Surg. 2009;35:1706–10. (83.5% of the entire study group reported satisfaction at 1 month). One prior smaller study of 10 pa- tients (12 eyes) by Galor et al. specif- ically looked at surgical outcomes of IOL exchange in dissatisfied patients with multifocal and accommodative IOLs. Galor found similar rates of satisfaction in these patients, with eight out of 10 of them reporting postoperative satisfaction. 5 Conclusion This study confirms late in-the-bag IOL dislocation remains the most common cause of IOL exchange surgery. Patient dissatisfaction is a growing indication for IOL ex- change, as seen in this study, and is likely to increase as patient expec- tations with cataract surgery rise. Despite the inherent risk of lens ex- change surgery, complications were rare in this study, and patients who undergo IOL exchange may achieve excellent outcomes. EW References 1. Mönestam EI. Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery. Ophthalmolo- gy. 2009;116:2315–20. 2. Jones JJ, et al. Indications and out- comes of intraocular lens exchange during a recent 5-year period. Am J Ophthalmol. 2014;157:154–62.e1. 3. Jin GJ, et al. Changing indications for and improving outcomes of intraocular lens ex- change. Am J Ophthalmol. 2005;140:688–94. 4. Lorente R, et al. Management of late spontaneous in-the-bag intraocular lens dislocation: Retrospective analysis of 45 Contact information Schallhorn: Julie.Schallhorn@ucsf.edu referral center: Intraocular lens exchange surgery at a tertiary referral center: Indications, complications, and visual outcomes Emma C. Davies, MD, and Roberto Pineda II, MD J Cataract Refract Surg. 2016;42(9). Article in press Purpose: Identify indications and visual outcomes for intraocular lens (IOL) exchange to understand recent changes in this surgery. Setting: Academic tertiary referral center Design: Retrospective chart review Methods: 109 cases identified by searching the institution's electronic medical record from January 2010 to September 2015 for patients treated by a single staff physician with the IOL exchange CPT code. These cases were reviewed to determine surgical indication, IOL removed, IOL implanted, time interval between surgeries, surgical complications, and visual outcome. Results: The mean time interval between primary cataract surgery and IOL exchange was 1,657 days. Dislocation of in-the-bag posterior chamber IOL (27.5%), intolerance of multifocal lens (18.3%), and uveitis-glaucoma-hyphema syndrome (11.9%) were the most frequent indications for IOL exchange. The final lens position after IOL exchange was most commonly in the capsular bag (43.1%), anterior chamber (25.7%), and sulcus (22%). Final visual acuity at 1 month was 20/40 or better in 78.9% of cases, and of those not achieving this level of vision, pathology not related to exchange surgery was identified in 48% of cases. The most common complications after IOL exchange surgery were posterior capsular opacification (13.8%), cystoid macular edema (10.1%), and high astigmatism (>1.5 diopters) (8.3%). Conclusions: The most common indication for IOL exchange surgery remains dislocated IOLs, but a recent second most common indication is patient dissatisfaction after multifocal IOL implantation. The increased ability to place an intracapsular lens with few intraoperative complications and largely treatable postoperative complications enhances the utility of IOL exchange surgery and patient satisfaction. That's all you need! One-size-fits-all punctum plug eliminates sizing and simplifies stocking Pre-stretched shape (on inserter) avoids dilation and facilitates insertion Expanded shape (once inserted) assures snug fit and virtually eliminates pop-out Soft collar prevents migration and provides patient comfort FCI-Ophthalmics.com 800.932.4202 Plug into FCI for Dry Eye Treatment and watch the SnugPlug insertion video. Visit PlugintoFCI.com for promotional pricing ™

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