Abstract

PurposeTo describe and present results after a technique for cataract surgery combined with explantation of an iris-fixated phakic intraocular lens (IF-pIOL).MethodsThe 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.ResultsFifty 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.ConclusionSIT 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.

Highlights

  • The implantation of a phakic intraocular lens allows treatment of refractive errors, with the advantage of sparing the crystalline lens

  • We describe the surgical technique of performing cataract surgery underneath the phakic intraocular lens (pIOL) in patients, previously treated with an Artisan or Artiflex (Ophtec BV) iris-fixated phakic intraocular lens (IF-pIOL) and we present the safety and visual and refractive outcomes of this procedure

  • We describe an alternative surgical approach, the Single Incision Technique (SIT), for cataract removal in patients with an IFpIOL in situ for myopia or hyperopia

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Summary

Introduction

The implantation of a phakic intraocular lens (pIOL) allows treatment of (high) refractive errors, with the advantage of sparing the crystalline lens. One of the most common anterior chamber pIOLs is the iris-fixated (IF) Artisan pIOL [1] and has been demonstrated to be an effective, predictable, and stable procedure for all models [1,2,3]. Graefe's Archive for Clinical and Experimental Ophthalmology anterior chamber pIOL. Explantation of the pIOL is combined with phacoemulsification and placement of a posterior IOL [9, 10]. This procedure carries the risk of additional ECD loss due to the phacoemulsification [11, 12] and manipulation of the pIOL in the anterior chamber

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