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Phakic intraocular lens Explantation. Causes in 282 cases: analytical review

Poster Details

First Author: J.Alio SPAIN

Co Author(s):    B. Toffaha   P. Pena   R. Barraquer   L. Sadaba     

Abstract Details


To define the main causes of explantation of phakic intraocular lenses (PIOLs)


Vissum Corporacion Alicante, Centro de Oftalmologia Barraquer and Clinica Universitaria de Navarra.


Consecutive multicentric retrospective study of explanted PIOL cases from different Spanish ophthalmological clinics was carried out. The study included angle supported PIOLs, iris fixated PIOLs and posterior chamber PIOLs. The causes of explantation were studied and the explanted IOL surfaces were analyzed by scanning electron microscopy (SEM).


A total of 282 explanted phakic IOLs of 268 patients were studied. Patients mean age when explantation occurred was 46.32 (SD 11.95) 23-80 years. 100 [37.3%] patients were male and 168 (62.7%) were female. The main causes for explantation were cataract formation with 148 (52.5%) cases. In all the cases, the cataracts were nuclear according to the LOCS III. The following cases of explantation were endothelial cell loss, 29 cases (10.3 %), corneal decompensation 14 eyes (5%), pupil ovalization 10 cases (3%), intraocular lens dislocation 12 eyes (4.3%), bullous keratopathy 6 eyes (2.1%). The cataract development was the cause of explantation in 53% of angle supported PIOL cases, 58% of iris fixated PIOLs and 60% of the posterior chamber PIOLs. Endothelial cell loss was the cause of explantation in 15.5% of angle supported PIOLs, 8.3% of iris fixated PIOLs, and 1.3% of posterior chamber PIOLs. Scanning electron microscopy (SEM) showed fibroblasts, melanosis, melanocytes and lipids deposits on some of the explanted lenses. Coco bacteria were found in 3 explanted posterior chamber phakic IOLs.


Cataract is the main cause for explantation of phakic IOLs. Endothelial cell loss is the second important cause. Scanning electron microscopy of the explanted lenses show the existence of fibroblasts, melanosis, melanocytes, lipids and coco bacteria on some explanted lenses. FINANCIAL DISCLOSURE?: No

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