Management of aphakia with low corneal endothelial cell count after complicated cataract surgery in a middle-age patient

Abstract

Background: secondary intraocular lens implantation becomes more challenging due to pre-existing conditions. Objective: To report the outcome of retropubic iris-claw intraocular lens (RP-ICIOL) to corrects aphakia with low corneal endothelial cell count following previous complicated cataract surgery. Case: A 32-year-old male was referred to Undaan Eye Hospital with a chief complaint of blurred vision in his left eye (LE). Previously, the patient was diagnosed with a mature subluxated cataract and has undergone cataract extraction on the LE. Visual acuity of LE was 1/60 with raised intraocular pressure (31,8 mmHg with Schiotz Tonometry). On anterior segment examination, there was a clear cornea with an oval pupil and aphakia. The examination of the posterior segment was within normal limits. Specular microscopy of LE was 1140 cells/mm2. After IOP was controlled by medication, the patient then underwent retropubic iris-claw intraocular lens implantation. Post-operatively, the visual acuity of the LE was 2/10 and the IOP was 11 mmHg using non-contact tonometry. Six weeks post-op, the best visual acuity (BCVA) was 9/10 and the IOP was 15 mmHg and the CECD was 1110 cells/mm2 on the LE. Discussion: The RP-ICIOL was maintaining the physiological condition of the IOL location posteriorly, thus minimizing the risk of corneal decompensation and increased postoperative intraocular pressure, while at the same time trying to achieve a good refractive outcome. Conclusion: The implantation of RP-ICIOL is safe and effective management of aphakia with a low corneal endothelial cell coun secondary intraocular lens implantation becomes more challenging.