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Endothelial decompensation after phakic intraocular lens implantation: two approaches

Poster Details

First Author: L.Fernandez-Vega Cueto SPAIN

Co Author(s):    C. Lisa   M. Naveiras   J. Alfonso        

Abstract Details



Purpose:

To analyse the outcomes of two different surgical approaches to solve endothelial decompensation due to previous phakic lens implant.

Setting:

Instituto Oftalmológico Fernández-Vega. Oviedo. Spain.

Methods:

Study of 2 patients referred to our center with very similar characteristics: endothelial decompensation induced by first-generation phakic intraocular lenses (pIOL) in one eye and very low endothelial cell count on the other eye. One patient had a bilateral implant of an I-care anterior-chamber angle-supported pIOL lens (Corneal, France) and the other a bilateral implant of an Artisan iris-claw pIOL (Ophtec, Groningen, Niederlande). Both patients had one of their pIOLs explanted before they came to our center and showed corneal endothelial cell density (ECD) below 900 cells/mm2 in the other eye, along with clear lens and progressive loss of visual acuity, which were ≤ 0.63 (decimal) in all eyes. We decided to explant the remaining pIOLs and perform DMEK on the other eye, where corneal edema was present. The lenses implanted in both cases were AT LISA 802 (Carl Zeiss Meditec AG, Germany) . The follow-up was 12 months in both cases. During this follow-up, visual acuity and ECD were recorded and analysed.

Results:

DMEK was a fast solution for the eyes having endothelial decompensation. The new endothelial cell counts were satisfactory and stable during the follow-up, with 1928 and 1713 cells/mm2. In the other eye, removing the pIOL solved the problem as well, at least during the follow-up. The cell counts of the eyes with the pIOL removed have been improving significatively, with more than 1100 cells/mm2 in the last visit. Visual acuities also improved during the follow up reaching 1.0 in all eyes.

Conclusions:

DMEK technique is an effective solution to endothelial decompensation induced by pIOLs. In cases where the endothelium is not yet decompensated early removal of the pIOL also solves the problem. FINANCIAL INTEREST: NONE

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