Anterior Chamber Phakic Iol Exchange For A Posterior Chamber Phakic Iol In Cases With Low Endothelial Cell Density
Published 2025 - 43rd Congress of the ESCRS
Reference: PO733 | Type: Free paper | DOI: 10.82333/r8j4-wt81
Authors: Leon Pomberger* 1 , Sophia Reifeltshammer 1 , Lisa Tasch 1 , Haidar Khalil 1 , Klemens Waser 1 , Matthias Bolz 1 , Nino Hirnschall 1
1Department of Ophthalmology and Optometry,Johannes Kepler University,Linz,Austria;Department of Ophthalmology and Optometry,Kepler University Clinic,Linz,Austria
Purpose
To report the outcomes of a Anterior chamber phakic IOL (intraocular lens) exchange for a posterior chamber collamer-based phakic IOL in cases with low endothelial cell density.
Setting
Instituto Universitario Fernández-Vega (Oviedo), Spain
Methods
Patients with low endothelial cell density secondary to anterior chamber phakic IOL implantation were recruited. Those young patients with clear natural lens that received an IOL exchange for a posterior chamber phakic IOL (ICL, Staar) through a 6mm scleral incisión were selected. Inclusion criteria were five years of minimum follow up after phakic IOL exchange and low endothelial cell count (<1500 cells/mm²). Main outcome measures included endothelial cell density, visual acuity, refraction, vault and postoperative complications
Results
15 eyes of 8 patients underwent anterior chamber phakic IOL explantation (9 iris fixated and 6 angle supported) for a posterior chamber phakic IOL (ICL, Staar). Six months after surgery, refraction, uncorrected and best corrected visual acuity and refractive and keratometric astigmatism were studied. Efficacy and safety index were 0,84 and 0,95 respectively. Average vault was 152 ± 174 microns. Average central endothelial cell density decreased from 992 cells/mm² pre-IOL exchange to 843 cells/mm² nine years after the surgery. In one eye endothelial keratoplasty surgery was done 1 year after the surgery due to endothelial decompensation. No other related complications developed after the surgery.
Conclusions
Anterior chamber phakic IOL exchange for a posterior chamber phakic IOL is a safe and predictable procedure in cases with low endothelial cell density