Secondary intraocular lens replacement: An expert's guide

Ms Evgenia Anikina is a highly-experienced consultant vitreoretinal surgeon based in London. In her latest online article, Ms Anikina offers her expert insight into secondary lens replacements, an operation that can greatly improve the patient’s quality of life.

How is secondary lens replacement performed?

In order to change an intraocular lens implant in your eye, you need to have an operation. Depending on the type of lens being exchanged and the type of lens being placed in the eye, the surgery will either be similar to the original cataract surgery, or involve a vitrectomy in addition – a procedure at the back of the eye. The length of the operation will vary between 15 minutes and over an hour, depending on the complexity of the procedure.

What eye conditions can secondary lens replacement correct?

This sort of procedure is usually required when some sort of problem is identified with the existing lens implant. This can be dislocation of the existing lens, opacification or lens dissatisfaction. With dislocation, the lens slips out of the correct position, resulting in blurring and other negative visual effects. Sometimes this happens following trauma, however often it can be due to a gradual age-related weakening of the support structures inside the eye.

With opacification, some lenses, especially those manufactured and implanted many years ago, can gradually become cloudy over time and start to impair visual quality. With lens dissatisfaction, the original plan for the post-operative prescription of the eye has failed to deliver the expected visual outcome and the patient is unhappy with their original choice and would like to change the lens focus.

Can both eyes be treated at the same time?

Yes, this is certainly possible, although cases of needing bilateral lens replacement are not common. If it is needed, then it is often preferable to do surgery on one eye at a time, to ensure visual satisfaction with one eye before proceeding on to the second.

What are the benefits, risks and possible side effects of surgery?

The benefit in all cases is improved vision, fewer negative visual effects and improved quality of visual function.

The risks are those of other similar intraocular procedures, namely a chance of developing post-operative inflammation and raised pressure, both requiring treatment with drops, bleeding and infection and visual loss – though serious problems resulting in permanent loss of vision are rare.

How does vision improve after secondary lens replacement?

This is very dependent on the reason for undertaking the surgery. If the previously implanted lens is completely dislocated, the vision is very blurred and a dramatic improvement from lens replacement is achieved. If the pre-operative vision is relatively mildly affected in quality by mild lens opacification, the improvement is naturally more modest.

Visual improvements on the vision testing chart do not reflect the full picture of vision quality, however. Often patients are very pleased with a reduction in the effect of haloes and glare, even if their overall vision measurement only shows mild changes.

How long can I expect my secondary intraocular lens(es) to last?

There is no “expiry date” on these lenses. They are designed to last for the rest of your life, barring accidents and rare lens dislocations.

Ms Evgenia Anikina is a highly-accomplished consultant vitreoretinal surgeon based in London. If you would like to book a consultation with Ms Anikina you can do so today via her Top Doctors profile.