Abstract: Objective To investigate the causes and precaution of intraocular lens (IOL) exchange. Design Retrospective case series. Participants 28 eyes which underwent IOL exchange in Peking University Third Hospital from April, 2012 to May, 2013. Methods The medical history, the causes and IOL dislocation, capsular rupture condition of these patients and precaution measures were analyzed. Main Outcome Measures Causes of IOL exchange, IOL dislocation and posterior capsule rupture condition. Results The causes of IOL exchange included bullous keratopathy with angle supported anterior chamber IOL (35.70%), IOL dislocation (50.00%) included complete dislocation in vitreous (35.70%) and dislocation with ischemic optic neuropathy (7.14%) and luxation with high myopia (7.14%), refractive error (7.14%) included one high myopia eye with wrong calculation IOL diopter and one eye high myopia shift after pediatric cataract surgery, IOL damage due to laser (7.14%). The precaution included improving surgery technique, avoiding implanting angle supported anterior chamber IOL, avoiding instantly increasing intraocular pressure during the surgery, correctly calculating IOL diopter etc. Conclusion The main causes of IOL exchange include IOL dislocation and bullous keratopathy induced by the angle supported anterior chamber IOL. It will be helpful to reduce the rate of IOL exchange if we can improve surgery techniques, avoid increasing intraocular pressure instantly, avoid angle supported anterior chamber IOL, increase laser therapy techniques, select suitable calculation formula for high myopia etc. (Ophthalmol CHN, 2015, 24: 100-102)

Key words: intraocular lens, intraocular lens dislocation, bullous keratopathy