Veronica Vargas1,2, Antonio Marinho3, Fouad El Sayyad1,2, Jorge L Alio Del Barrio1,2,4, Jorge L Alio1,2,4,5. 1. Cornea, Cataract and Refractive Surgery Department, VISSUM, Alicante, Spain. 2. Research & Development Department, VISSUM, Alicante, Spain. 3. Hospital da Luz Arrábida Porto, Portugal. 4. Universidad Miguel Hernández, School of Medicine, Alicante, Spain. 5. IBERIA eye bank, Oftalred, Universidad Miguel Hernández, Alicante, Spain.
Abstract
PURPOSE: To evaluate the visual outcomes, safety, efficacy, and causes of bilensectomy for iris fixated phakic intraocular lenses (pIOLs). METHODS: This was a two center consecutive retrospective study that included 43 eyes that underwent iris-claw pIOL bilensectomy. Patients with follow up less than 4 months were excluded from the study. Uncorrected, corrected visual acuity (UCVA, CDVA), refractive outcomes, efficacy, safety (number of eyes in which the postoperative CDVA was worse than the preoperative CDVA), endothelial cell density (ECD), causes of bilensectomy, the time between the implantation of the pIOL and bilensectomy, intra and postoperative complications were analyzed. RESULTS: There was a statistically significant improvement in UCVA and CDVA after surgery (p = 0.001). The efficacy index was 0.7, four eyes had a postoperative CDVA worse than the preoperative CDVA. The mean spherical equivalent 1 year after bilensectomy was -0.78 ± 1.70 D. There was a statistically significant endothelial cell loss after iris claw lens bilensectomy (p = .003). Cataract development and endothelial cell loss were the only reasons for bilensectomy. The mean time between pIOL implantation and bilensectomy was 12.2 ± 5.5 years. One patient had corneal edema 8 months after surgery and one had a retinal detachment 11 months after surgery. CONCLUSION: Bilensectomy was successful in improving UCVA and CDVA with an acceptable refractive outcome. Significant loss of ECD was found after surgery. The results recommend a larger ACD as selection criteria when choosing to implant an Artisan lens, and a close postoperative monitoring of the endothelial cell count.
PURPOSE: To evaluate the visual outcomes, safety, efficacy, and causes of bilensectomy for iris fixated phakic intraocular lenses (pIOLs). METHODS: This was a two center consecutive retrospective study that included 43 eyes that underwent iris-claw pIOL bilensectomy. Patients with follow up less than 4 months were excluded from the study. Uncorrected, corrected visual acuity (UCVA, CDVA), refractive outcomes, efficacy, safety (number of eyes in which the postoperative CDVA was worse than the preoperative CDVA), endothelial cell density (ECD), causes of bilensectomy, the time between the implantation of the pIOL and bilensectomy, intra and postoperative complications were analyzed. RESULTS: There was a statistically significant improvement in UCVA and CDVA after surgery (p = 0.001). The efficacy index was 0.7, four eyes had a postoperative CDVA worse than the preoperative CDVA. The mean spherical equivalent 1 year after bilensectomy was -0.78 ± 1.70 D. There was a statistically significant endothelial cell loss after iris claw lens bilensectomy (p = .003). Cataract development and endothelial cell loss were the only reasons for bilensectomy. The mean time between pIOL implantation and bilensectomy was 12.2 ± 5.5 years. One patient had corneal edema 8 months after surgery and one had a retinal detachment 11 months after surgery. CONCLUSION: Bilensectomy was successful in improving UCVA and CDVA with an acceptable refractive outcome. Significant loss of ECD was found after surgery. The results recommend a larger ACD as selection criteria when choosing to implant an Artisan lens, and a close postoperative monitoring of the endothelial cell count.
Entities:
Keywords:
Iris-claw phakic intraocular lenses; bilensectomy; cataract surgery; cataract surgery complications; endothelial cell density
Authors: Zoraida Solaiga Gaurisankar; Gwyneth A van Rijn; Yanny Y Y Cheng; Gregorius P M Luyten; Jan-Willem M Beenakker Journal: Graefes Arch Clin Exp Ophthalmol Date: 2021-10-16 Impact factor: 3.117