UNDO THE PAST SOLUTION - A CASE SERIES ON PHAKIC INTRAOCULAR LENS EXPLANTATION

Retrospective case series of patients who underwent phakic intraocular lens explantation in our institution from 2018 to the present. Lens placement surgery could have been performed at our surgical center or another one, possibly limiting the access to data in a number of patients. Indication for explantation and visual and refractive outcomes were examined.

Twenty-three eyes of 14 patients underwent phakic intraocular lens explantation with a mean time to explantation (average lens age) of 140 ± 40,6 months (11,7 years). The mean age at explantation was 46 ± 3,9 years. Sixteen Artisan and seven Artiflex intraocular lens were explanted. Main indication for explantation was endothelial cell loss (n=14) and cornea dystrophy. Mean corrected vision after explantation was 0,8 ± 0,4 logMAR, and around 70% of intervened patients achieved visual acuity of at least 0,3 logMAR (0,5 in decimal scale). Three patients with endothelial cell loss required a Descemet Membrane Endothelial Keratoplasty (DMEK).

In our group series, the main reason for removal of phakic intraocular lens was endothelial cell loss. This complication should be monitored and followed, so that early actions, namely intraocular lens explantation, allow to avoid the development of deterioration requiring corneal transplantation. In fact, loss of follow-up, often for several years, continues to be a serious problem, found in several cases.