Purpose:

To evaluate the complications the of IOL exchange using the scaffold technique and other measures

Methods:

Retrospective chart review of nine consecutive cases from July 2016 to September 2017. All procedures were performed by one surgeon in the setting of private practice. Indications for the procedure were malfunctional intraocular lens implant (photic phenomeno, loss of stereopsis, incorrect refractive power ) in 67 percent of the cases and malposition intraocular lens in 33 percent. The surgical technique involves releasing the original intraocular lens and shifting above the iris level followed by the insertion of a new IOL in the bag or sulcus that works as a barrier for the posterior capsule or posterior cahmber while maneuvering, cutting and explanting the original implant .

Results:

Using the scaffold technique for IOL exchange resulted in no loss of visual acuity. Mean visual acuity before the surgery was logMAR 0.13. Mean visual acuity after the procedure was logMar 0.03. Mean astigmatism induced by the procedure was +0.37 cylinder. One complication involved a broken haptic of a three piece intraocular lens while been inserted due to poorly loading in the cartridge resulting in explantation. The second compliaction was development of posterior capsule opacification . Due to the small number of cases it is difficult to draw a statistical significant conclusion

Conclusions:

In the scaffold technique the new intraocular lens protects the posterior capsule from tearing and possible vitreous loss as well preventing a piece of implant to fell into the vitreous while cutting before explantation through an small corneal incision increasing the safety of the intraocular lens exchange procedures. The technique is efficient and has a fast learning curve .