Two-year results after combined phacoemulsification and iris-fixated phakic intraocular lens removal

Abstract

Purpose To describe and present results after a technique for cataract surgery combined with explantation of an iris-fixated phakic intraocular lens (IF-pIOL). Methods The medical records of all patients, who had undergone cataract surgery combined with IF-pIOL explantation and subsequent implantation of a posterior chamber IOL by the Single Incision Technique (SIT), were reviewed. Data collection included preoperative and postoperative corrected distance visual acuity (CDVA), manifest refraction, and endothelial cell density (ECD) up to a follow-up time of 24 months. Results Fifty myopic eyes (34 patients) and 9 hyperopic eyes (6 patients) had undergone a SIT procedure mainly because of cataract (67%). Postoperative CDVA improved in both the myopic eyes to 0.16 ± 0.37 logMAR, as in the hyperopic eyes to − 0.10 ± 0.55 logMAR with no eyes having loss of Snellen lines. Mean postoperative spherical equivalent was − 0.34 ± 0.72 D and − 0.10 ± 0.55 D, respectively. ECD loss 6 months after surgery was 5% and remained stable thereafter. Conclusion SIT for combined phacoemulsification and IF-pIOL removal yields good visual and refractive results and is a safe procedure in regard to ECD loss. The technique has advantages over the conventional procedure and is easy to perform.

Endothelzellverlust bei phaken Intraokularlinsen

“…However, the findings from published studies differ greatly. Both Gaurisankar et al and de Vries et al observed only a small rate of endothelial cell loss after the combined operation (mean cell loss of 3.5-9.4 %) [81,82]. In contrast, Vargas et al reported a considerably higher rate of endothelial cell loss (approx.…”

“…Es bestehen jedoch große Unterschiede zwischen den veröffentlichten Studien. Gaurisankar et al sowie de Vries et al stellten nur einen geringen Endothelzellverlust nach der kombinierten Operation fest (mittlerer Verlust von 3,5 – 9,4%) 81 , 82 . Vargas et al berichteten hingegen über einen deutlich höheren Endothelzellverlust (ca.…”

Diagnostic Techniques to Increase the Safety of Phakic Intraocular Lenses

“…While the pIOL implantation itself can cause endothelial cell loss, it is usually limited to 4-8% [11,16,18,22,28,[58][59][60][61][62][63][64]. Larger losses can occur during pIOL explantation, alone or when combined with the cataract surgery [21,[65][66][67]. One study found a statistically significant endothelial cell loss (27% decrease in mean ECD) in patients with iris-fixated lenses when cataract was the indication for the combined surgery, but not in those who underwent the combined surgery because of endothelial cell loss, suggesting that endothelial damage due to phacoemulsification is the primary reason for the decreased ECD [10,67].…”