Long Term Visual And Refractive Outcomes Of Cataract Surgery Following Posterior Chamber Phakic Intraocular Lens Explantation
Published 2026 - 44th Congress of the ESCRS
Reference: POREF155 | Type: Free paper | DOI: 10.82333/wgk0-rt77
Authors: Dr Tamilarasi S* 1 , Dr Ramamurthy D 2 , Dr Zunaitha Fathima 1
1Cataract ,The Eye Foundation ,Coimbatore ,India, 2Cataract and Refractive Services ,The Eye Foundation ,Coimbatore ,India
Purpose
To evaluate long-term visual outcomes, refractive predictability, and safety of cataract surgery following posterior chamber phakic intraocular lens (PCpIOL) explantation.
Setting
Tertiary eye care center, South India.
Methods
Retrospective interventional case series of 57 eyes undergoing PCpIOL explantation combined with phacoemulsification and IOL( Intraocular lens) implantation for cataract between 2009 and 2022. Minimum follow-up was 2 years. Primary outcomes included corrected distance visual acuity (CDVA), refractive accuracy, and intraoperative and postoperative complications. Phacoemulsification was performed in 54 eyes and femtosecond laser–assisted cataract surgery in 3 eyes. IOL power calculation was performed using the Barrett Suite formula.
Results
Anterior subcapsular cataract was the most common indication for explantation. Explanted models included ICL(Implantable Collamer Lens) V4b, IPCL (Implantable Phakic Contact Lens) V1, and IPCL V2.
Mean interval between PCpIOL implantation and cataract surgery was 8.3 ± 4.5 years. Mean axial length was 30.3± 2.4 mm. No significant difference was observed between target refraction (−0.1± 0.4 D) and achieved spherical equivalent (−0.3± 0.9 D; p = 0.228).
Postoperatively, 80.6% of eyes achieved CDVA ≤0.3 logMAR, and 86.1% were within ±1.00 D of target refraction.
No intraoperative or early postoperative complications occurred. During follow-up, posterior capsular opacification developed in 11 eyes and rhegmatogenous retinal detachment in 1 eye.
Conclusions
Cataract surgery following PCpIOL explantation provides favorable long-term visual and refractive outcomes with a high safety profile, even in highly myopic eyes. The Barrett Suite formula demonstrated reliable IOL power prediction in this complex cohort. Despite advancements in PCpIOL geometry, accurate sizing remains crucial to prevent complications. Comprehensive retinal evaluation and regular postoperative follow up are essential to ensure optimal outcomes in these highly myopic eyes.