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ASCRS Foldable IOL Survey

IOLs Explanted or Requiring Secondary Intervention

 The ASCRS Foldable IOL Survey evaluates the reasons for explanations and secondary intervention in complications related to foldable IOLs. Results become part of an ongoing registry of foldable IOL complications. An update of the latest results will be presented at the 2008 annual symposium in Chicago, Illinois.

Please complete 1 form for each foldable IOL that you explant or that requires a secondary intervention. To complete form, click the box in front of the appropriate answer. When complete, click the submit button.

 
Date of Implantation (please include month, date, and year):

Date of Explantation (please include month, date, and year):

1)      Preoperative best corrected visual acuity:
 
20/20 - 20/40
20/50 - 20/100
20/200 - 20/400
Worse than 20/400
Unknown
2) Explanted foldable IOL lens style:

Three Piece
One Piece (Plate)
Multifocal
3) Explanted IOL optic material:
Silicone
Acrylic
Hydrogel
Unknown
4) Lens Manufacturer (if known):


5) IOL Model or Number (if known):


6) Complication requiring removal of lenses:


Dislocation/decentration
Incorrect lens power
Corneal edema/bullous keratopathy
Iritis UGH syndrome
Glaucoma
Damaged IOL - cracked or torn
Retinal problems/RD
Removed during retinal surgery
Infection/endophthalmitis
Cystoid macular edema
Operative complications
Glare/optical aberrations
Unknown
7) Patient signs and symptoms at time of IOL explantation:
  Visual loss
Pain/discomfort
Ocular inflammation
Increased intraocular pressure
Visual aberration/optical phenomenon (glare, halos, rings, arcs or light)
Cosmetic appearance/reflection
Other/specify:
Unknown
8) Was explanted IOL exchanged?:
  Yes
No
9) What type of IOL was used for IOL exchange?:
 
10) Secondary interventions not requiring IOL removal:
  Sutured dislocated IOL
Repositioning of IOL
Piggyback or additional IOL insertion
Capsular tension ring
Other
11) Post-explantation best corrected visual acuity:
  20/20 - 20/40
20/50 - 20/100
20/200 - 20/400
Worse than 20/400
Unknown
12) Post-explantation complications:
  Pain/irritation
 Ocular inflammation
 Corneal edema/bullous keratopathy
 Glaucoma
 Retinal problems/RD
 Cystoid macular edema
 Piggyback IOL related problems
 Other/specify:
Comments:
 
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