Reasons In Explantations Of Posterior Chamber Phakic Intraocular Lenses In 880 Eyes.

The aim is to evaluate the reasons in posterior chamber phakic intraocular lens (PCPIOL) removal/replacement in a series of 880 implantable collamer lens (ICL)-implanted eyes.

WORLD EYE HOSPITAL ISTANBUL TURKIYE

For the study, the files of 880 eyes which underwent ICL implantation between January 2015 and November 2020 were reviewed. Uncorrected and corrected distance visual acuities, spherical and cylindrical refraction values before and after ICL explantation, vault measurements, reasons for removal, time interval from the implantation to the removal, and management were evaluated.

All myopic eyes (816 eyes) were treated by V4c model ICL with a central hole. The remaining 64 eyes were hyperopic . Explantation/exchange was required in 16 eyes. High vault (more than 1300 µm) was the reason for explantation in 8 eyes (50% of all explantations), low vault (less than 50 µm) was the cause of the explantation in one eye which was hyperopic case . Two eyes presented with retinal detachment and ICLs were removed. Lens exchange was performed in two eyes due to intraoperative haptic damage, in two eyes due to upside down implantation, and in one eye due to recurrent torsion of the toric ICL and changing with larger size of ICL. No complication related to explantation surgery were observed in the study series.

Improper sizing of ICL and the related vault problems are the main reasons for the ICL explantations. The accurate measurement of ICL size and early management of low or high vault after ICL implantation will prevent late complications including cataract and glaucoma.