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Outcomes of cataract surgery after phakic intraocular lens implantation

Poster Details

First Author: S.Nanaiah INDIA

Co Author(s):    M. Kummelil   S. Nagappa   R. Shetty   S. Das   B. Shetty  

Abstract Details



Purpose:

To evaluate the outcome of cataract surgery after phakic intraocular lens implantation

Setting:

Tertiary eye care and research centre

Methods:

This retrospective case series, evaluates the outcome of cataract surgery in patients who developed cataract after implantation of a phakic intraocular lens [Visian Implantable collamer lens (ICL), Staar surgical company, CA] for high myopia. The time of onset of cataract after phakic IOL implantation, type of cataract and outcome of cataract surgery in these patients was evaluated. Any significant intra operative or post operative events that might have occurred was noted. The anterior chamber depth before ICL implantation and the vault of the ICL in the eye at the time of development of cataract was noted. All patients underwent ICL explantation with phacoemulsification and implantation of intraocular lens (IOL). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and residual refractive error were compared between after ICL implantation to after cataract surgery.

Results:

Of the 1050 cases operated at our centre(7 years follow up) , 2 patients developed cataract. The age at development of cataract was 44 years in case 1 and 42 years in case 2. The first patient developed cataract after 4 years and the second 3 years after ICL implantation. The anterior chamber depth was 3.1 and 2.9 respectively which followed required protocols. The ICL vault was 0.407 and 0.468 microns respectively. The first patient developed anterior subcapsular with nuclear cataract and the second patient had only grade 2 nuclear cataract. Uncorrected visual acuity (logmar: 0.17& 0.5 vs 0.15 & 0.15) and residual refractive error was better after cataract surgery than after ICL implantation in both cases. Best corrected visual acuity (0.15 & 0.15 vs 0.15 & 0) was either better or comparable after cataract surgery. A third patient operated elsewhere presented with cortical cataract 8 months after ICL implantation. His preoperative vision was not available. He attained a UCVA of 0.15 and BCVA of 0 on LogMar.

Conclusions:

Detailed pre operative evaluation to rule out pre-existing cataract is extremely important. The prevalence of cataract after ICL implantation in our centre was found to be 0.002. No intraoperative complications were associated with the development of cataract. Uncorrected visual acuity and best corrected visual acuity were found to be better after cataract surgery as compared to after ICL implantation. The final outcome of ICL explantation with phacoemulsification and implantation of IOL was found to be satisfactory FINANCIAL INTEREST: NONE

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