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Results of cataract surgery with phacoemulsification after implantation of an iris-fixated phakic intraocular lens

Poster Details

First Author: D.Klaas GERMANY

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Abstract Details


To report the results and advantages of phacoemulsification after prior implantation of an iris-fixated phakic intraocular lens (Artisan pIOL) for the correction of high myopia without explantation of the pIOL.


Augenzentrum Friedberg / Augsburg


This study comprises 8 eyes in 6 patients who developed cataract after previously having undergone refractive pIOL surgery to correct high myopia. All eyes received phacoemulsification with in-the-bag implantation of a posterior chamber IOL without the explantation of the pIOL. Surgical technique included: Limbal incision 2.5mm, endothelial protection through Viscoat and the pIOL serving as a protection shield, CCC 5.5mm, Viscodelineation and Viscosplit of the lens nucleus to get small lens-fragments. Phaco with low machine-settings and low infusion-height. Individual calculation of the correct power of the IOL was based on the formula of Gullstrand's theoretical analyses.


Maximum follow-up time after pIOL surgery was 19 years, after cataract-surgery 10 years. Time of cataract-incidence was 9 to 12 years. Predictability of the refraction was -0.5 ± 0.75 (SD). After cataract surgery we found no BCVA decrease, no significant endothelial cell loss and a significant increase of the AC depth (30-40%). Main advantages of this method compared to subsequent explantation of the pIOL with a large incision (6.5-7mm) are a smaller incision size (2.5mm), less surgically induced astigmatism, less endothelial damage with a possible additional protective function of the pIOL.


Good predictability of the desired postoperative refraction, excellent visual rehabilitation and overall less complication rates are the main advantages of cataract surgery with phacoemulsification posterior to the pIOL without explantation of the anterior chamber lens. With regards to the difficulties of the surgical procedure this method is mainly recommended for experienced phaco-surgeons. Cataract development after refractive pIOL surgery in high myopia can be a challenge, which we were able to solve with the described method.

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