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Nuclear cataract and ocular hypertension following Kelman Duet Phakic IOL (PIOL) implantation: case report and explantation video

Poster Details

First Author: G.Fernandez-Baca SPAIN

Co Author(s):    C. Perez Casaseca              

Abstract Details


To report a case of a 52 year old female patient who underwent a Kelman Duet PIOL (Tekia, Inc) implantation for high myopia in both eyes and PRK enhancement in right eye. This angle supported PIOL incorporates two separate supporting parts. The haptic and the optic are separately implanted and then fixed together inside the anterior chamber. The surgeon have three choices for the PMMA haptic size and a 6.3 mm silicone optic with a glare shield


Hospital Regional Universitario de Malaga, Spain


Seven years after implantation we found a nuclear cataract in both eyes, probably unrelated to the PIOL and a previously diagnosed ocular hypertension treated with brimonidine tartrate/timolol maleate ophthalmic solution (Combigan, Allergan). Her visual acuity was 20/60 (-1 a 20º, -1) in RE and 20/60 (-6) in LE. We explanted both PIOLs , separating both pieces inside the anterior chamber. We followed through a 2.75 mm incision, taking out the silicone optic and finally the rigid PMMA haptics. The next step in our surgery was phacoemulsification and a posterior chamber IOL implantation (SN60WF, Alcon, Fort Worth, TX).


Four months after last surgery her visual acuity is 20/30 (-1,75 a 115º, +1) in RE and 20/30 (-0,75 a 115º, -1) in LE. Her anterior segment revealed a correct pseudoaphakia in both eyes, intraocular pressure is controlled in 18 mmHg with brinzolamide/ timolol maleate ohthalmic solution (Azarga, Alcon) , in both eyes. On funduscopy, we found a visually irrelevant myopic maculopathy


Kelman Duet Phakic IOL implantation is a singular procedure due to the rare way of assembling in the anterior chamber. Long terms complications of this kind of PIOL has not been studied in large series of patients. We present a complication of this unique anterior chamber phakic IOL and the way to explant the lens through a 2,75 mm incision, controlling medically her IOP after the surgery

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