Long-term results of implantation of phakic posterior chamber IOLs

Abstract

In their article about the long-term results of phakic posterior chamber intraocular lens (IOL) implantation, Lackner et al.1 present the complication rates of cataracts in patients with a phakic posterior chamber IOL with 3 years of follow-up. It is noted that in 76 eyes of patients with a mean age of 48.3 years, there were 11 cases (14.5%) of cataract, of which 5 (45.5%) were progressive and 3 of the 5 eventually required cataract extractions. The authors conclude that the age of the patient is an important risk factor for the development of lens opacification. They also conclude that if one were to follow the suggested criteria in which surgery is performed only in those younger than 45 years of age, the opacification rate would decrease to 5.0%. Whereas 6 cases were presented with early opacification implying intraoperative trauma, 5 cases had late presentation with no apparent predisposing factor. This represented a 6% rate of late cataract complication in which age appears to be the only factor. Considering the number of phakic IOLs implanted each year, it is likely that cataracts can present at a much earlier age in this group of patients as they get older. We think that in contrast to the authors' conclusion, excluding patients over a certain age may only reduce the incidence of cataracts in the medium term. Long-term results must be validated. Arthur C.K. Cheng MRCSEd Kenneth S.C. Yuen MRCSEd Dennis S.C. Lam FRCS, FCROphth Hong Kong SAR, People's Republic of China