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Phakic intraocular lens explantation: incidence and causes
Session Title: Phakic IOLs and keratoconus or high astigmatism
Session Date/Time: Sunday 06/10/2013 | 17:00-18:30
Paper Time: 17:06
Venue: Elicium 1 (First Floor)
First Author: : L.Wielders THE NETHERLANDS
Co Author(s): : M. Doors A. Aerts R. Nuijts
To evaluate the incidence and causes for phakic intraocular lens (pIOL) explantation in a single centre.
University Eye Clinic Maastricht, the Netherlands.
Retrospective analysis of pIOL explantations in a tertiary medical centre over the past seven years (January 2006 - February 2013).
Between May 1998 and February 2013, 1047 pIOLs were implanted in our clinic, including 517 Artisan, 366 Artiflex and 164 Acrysof Cachet lenses. In 63 cases (6%) an explantation was performed (group 1). Three percent (34/1047) was explanted for cataract and 2% (20/1047) for severe endothelial cell (EC) loss.
In addition, since January 2006, twenty patients (29 eyes) were referred for pIOL explantation after implantation elsewhere (group 2). The reason for explantation in the combined groups was cataract in 48% (44/92) and EC loss in 40% (37/92) of cases. Twelve percent (11/92) of pIOLs were explanted for other reasons, including optical complaints and synechiae formation.
The incidence and causes for explantation varied between different types of pIOLs, with the highest incidence in the Artisan Hyperopia group. Sixteen percent of hyperopic Artisan lenses (5/32) were all explanted for severe EC loss.
Mean (±SD) time between implantation and explantation for EC loss was 7.5±3.0 years (range: 2-13). Mean EC density before explantation was 1048±455 cells/mm2 (363-1825): a decrease of 56±18% (28-81) from baseline. Patients were lost to follow-up for 2.8±2.6 years (1-9) before pIOL explantation for EC loss. Two patients returned to follow-up only upon development of endothelial decompensation requiring corneal transplantation.
Of 1047 pIOLs implanted in our centre, 2% had to be explanted for severe EC loss at a mean of 7.5 years postoperatively. Therefore, strict postoperative follow-up is of utmost importance in all patients undergoing pIOL implantation.