Angle-Supported Anterior Chamber Phakic Intraocular Lens Explantation: Causes and Outcome
Received 24 August 2005; accepted 30 May 2006. published online 21 September 2006.
Purpose
To investigate the reasons for explantation of angle-supported phakic intraocular lenses (IOLs) as well as the outcome and safety of the explantation procedure.
Design
Consecutive retrospective series.
Participants
One hundred eyes of 66 patients who underwent phakic angle–supported IOL explantation.
Intervention
Surgical explantation of anterior chamber angle–supported phakic IOLs.
Main Outcome Measures
Visual acuity, refraction, and endothelial cell density.
Results
The main causes of explantation were cataract development (64 cases [64%]), progressive endothelial cell loss (24 cases [24%]), and pupil ovalization (10 cases [10%]). According to the reason for phakic IOL explantation and the condition of the eye at time of explantation, 92 cases underwent bilensectomy (phakic IOL explantation followed by phacoemulsification of the crystalline lens), 2 cases underwent phakic IOL exchange, 4 cases underwent concomitant phakic IOL explantation and penetrating keratoplasty, and 2 cases underwent simple explantation of a phakic IOL. The mean time between phakic anterior chamber IOL implantation and explantation due to cataract was 10.04±3.66 years (range, 2–14). The mean time between implantation and secondary intervention due to progressive endothelial cell loss was 8.97±2.21 years (range, 2–14), and most of these cases were related to a specific model of angle-supported phakic IOL.
Conclusion
Nuclear cataract was the most frequent reason for angle-supported phakic IOL explantation. Bilensectomy was effective and maintained the refractive benefits obtained with phakic IOL implantation. Few cases developed severe endothelial cell loss, most of them related to certain types of phakic IOLs.
1Department of Refractive Surgery, Instituto Oftalmológico de Alicante, Vissum, and Division of Ophthalmology, Medical School, Miguel Hernández University, Alicante, Spain.
2Instituto Oftalmológico de Alicante, Vissum, and Medical School, Miguel Hernández University, Alicante, Spain.
3Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
4Instituto Castroviejo, Universidad Complutense de Madrid, Madrid, Spain.
Correspondence to Jorge L. Alió, MD, PhD, Instituto Oftalmológico de Alicante, Avda. Denia, s/n (Edificio VISSUM), 03016 Alicante, Spain.
Manuscript no. 2005-809.
The authors have no financial interest in any of the medical devices included in the article and no proprietary interest in the development or marketing of materials used in the study.
Supported in part by the Spanish Ministry of Health, Madrid, Spain (grant no.: Red Tematica de Investigación en Oftalmologia, Subproyecto de Cirugia y Refractiva y Calidad Visual CO3/13), and Spanish Generalitat Valenciana, Valencia, Spain (grant no.: Grupos05/036 [grants and support for scientific research and technological development in the Comunidad Valenciana for 2005]).
ABSTRACT