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

Abstract

To report the results of cataract surgery after previous implantation of an Artisan iris-fixated phakic intraocular lens (pIOL) for the correction of myopia. University center and private practice. This study comprised eyes with previous implantation of an iris-fixated pIOL to correct myopia and subsequent pIOL explantation combined with cataract surgery and in-the-bag implantation of a posterior chamber IOL. Predictability of refractive results, changes in endothelial cell density (ECD), and postoperative best corrected visual acuity (BCVA) were analyzed. The mean follow-up after cataract surgery in the 36 eyes of 27 consecutive patients was 5.7 months +/- 7.5 (SD). The mean time between pIOL implantation and cataract surgery was 5.0 +/- 3.4 years. After explantation of the pIOL and subsequent cataract surgery, the mean spherical equivalent (SE) was -0.28 +/- 1.11 diopters (D); the SE was within +/-1.00 D of the intended correction in 72.2% of patients and within +/-2.00 D in 86.1% of patients. The mean endothelial cell loss after the combined procedure was 3.5% +/- 13.2% and the mean postoperative BCVA, 0.17 +/- 0.18 logMAR. In patients with a history of implantation of an iris-claw pIOL for the correction of myopia, cataract surgery combined with explantation of the pIOL yielded acceptable predictability of the postoperative SE and minimal loss of ECD, resulting in a gain in BCVA.