Results of cataract surgery after implantation of an iris-fixated phakic intraocular lens

• Published in: Journal of cataract and refractive surgery Vol. 35; no. 1; pp. 121 - 126
• Main Authors: de Vries, Niels E., MD, Tahzib, Nayyirih G., MD, PhD, Budo, Camille J., MD, Webers, Carroll A.B., MD, PhD, de Boer, Ruben, MD, Hendrikse, Fred, MD, PhD, Nuijts, Rudy M.M.A., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2009; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Cell Count; Device Removal; Endothelium, Corneal - pathology; Follow-Up Studies; Humans; Iris - surgery; Lens diseases; Lens Implantation, Intraocular - methods; Medical sciences; Middle Aged; Myopia - surgery; Ophthalmology; Phacoemulsification; Phakic Intraocular Lenses; Polymethyl Methacrylate; Postoperative Complications; Prognosis; Refraction, Ocular - physiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Tomography, Optical Coherence; Visual Acuity - physiology; Eye disease; Cataract; Iris (eye); Lens disease; Treatment; Surgery; Implantation; Ophthalmology; Intraocular lens; Anterior segment disease
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2008.10.012

Purpose To report the results of cataract surgery after previous implantation of an Artisan iris-fixated phakic intraocular lens (pIOL) for the correction of myopia. Setting University center and private practice. Methods This study comprised eyes with previous implantation of an iris-fixated pIOL to correct myopia and subsequent pIOL explantation combined with cataract surgery and in-the-bag implantation of a posterior chamber IOL. Predictability of refractive results, changes in endothelial cell density (ECD), and postoperative best corrected visual acuity (BCVA) were analyzed. Results The mean follow-up after cataract surgery in the 36 eyes of 27 consecutive patients was 5.7 months ± 7.5 (SD). The mean time between pIOL implantation and cataract surgery was 5.0 ± 3.4 years. After explantation of the pIOL and subsequent cataract surgery, the mean spherical equivalent (SE) was −0.28 ± 1.11 diopters (D); the SE was within ±1.00 D of the intended correction in 72.2% of patients and within ±2.00 D in 86.1% of patients. The mean endothelial cell loss after the combined procedure was 3.5% ± 13.2% and the mean postoperative BCVA, 0.17 ± 0.18 logMAR. Conclusions In patients with a history of implantation of an iris-claw pIOL for the correction of myopia, cataract surgery combined with explantation of the pIOL yielded acceptable predictability of the postoperative SE and minimal loss of ECD, resulting in a gain in BCVA.