Explantation of phakic intraocular lenses: causes and outcomes
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ORIGINAL PAPER
Explantation of phakic intraocular lenses: causes and outcomes M. E. Sucu . S. Cakmak . Y. Yildirim N. Kandemir Bes¸ ek . T. Yasar
. B. Kepez Yildiz . G. Yalc¸ınkaya .
Received: 17 June 2020 / Accepted: 29 August 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To describe reasons for explantation of anterior and posterior chamber phakic intraocular lenses (pIOLs), as well as outcomes of the surgery. Methods The medical files of patients who underwent pIOL explantation due to complications were reviewed. All patients were divided into three groups based on the type of explanted pIOL: anterior chamber angle-supported (AS pIOL), anterior chamber irisfixated (IF pIOL), and posterior chamber (PC pIOL). Results Sixty-two eyes of 41 patients were evaluated. There were 26 (41.9%), 16 (25.8%), and 20 (32.2%) eyes in the AS pIOL, IF pIOL, and PC pIOL groups, respectively. The mean interval between the implantation and removal of the pIOL (i.e., survival time) was 13.6 ± 8.1 years (range 0.01–21.22 years). The mean follow-up after the explantation was 22.5 ± 4.0 months (range 11.3–28.7 months). The main causes of explantation were cataract in the PC pIOL group (60%) and chronic endothelial cell loss in the AS pIOL group (53.8%) and IF pIOL group (56.2%). Overall, the procedure most often combined with pIOL explantation was phacoemulsification and implantation of a posterior chamber IOL (40.3%),
M. E. Sucu S. Cakmak Y. Yildirim (&) B. K. Yildiz G. Yalc¸ınkaya N. K. Bes¸ ek T. Yasar Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, 34420 Istanbul, Turkey e-mail: [email protected]
followed by keratoplasty (9.6%). Intraoperative complications were significantly more common in the AS pIOL group than the other groups (p \ 0.001). Conclusions Explantation of anterior chamber pIOLs due to severe endothelial cell loss and the proportion of keratoplasty was more common in patients with a relatively long survival time. Therefore, patients with pIOL implantation should be monitored regularly after surgery. Keywords Phakic intraocular lens pIOL Anglesupported Iris-fixated Explantation
Introduction The first study regarding phakic intraocular lens (pIOL) implantation dates back to 1953 [1]. However, earlier pIOLs mostly had to be explanted due to a high complication rate [2]. Since then, the design and surgical techniques of pIOLs have been improved, and three types of pIOL have eventually become available on the market: anterior chamber angle-supported (AS pIOL), anterior chamber iris-fixated (IF pIOL), and posterior chamber (PC pIOL) [3]. The main advantages of pIOLs include reversibility, high optical quality, line gain in myopic patients due to image magnification, and preservation of accommodation [4, 5] Several studies [6–9] have reported the safety, efficacy, and high predictability of
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pIOLs, but their follow-ups were short or medium lengths and were usually
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