Journal of Cataract & Refractive Surgery

JOURNAL OF CATARACT & REFRACTIVE SURGERY

Volume 43 – Issue 6 – p 748-753

06/16

Authors :

  • P. Meier
  • F. Majo
  • P. Othenin-Girard
  • C. Bergin
  • I. Guber

Refractive outcomes and complications after combined copolymer phakic intraocular lens explantation and phacoemulsification with intraocular lens implantation

ABSTRACT

Purpose 

To assess safety, efficacy, and predictability of combined Implantable Collamer Lens phakic intraocular lens (pIOL) explantation and phacoemulsification and to report the rate of complications. A secondary aim was to examine whether intraocular lens (IOL) power calculation was affected by the pIOL in situ.

Setting 

Jules-Gonin Eye Hospital, Lausanne, Switzerland.

Design 

Retrospective case series.

Methods 

The records of patients having pIOL implantation with subsequent phacoemulsification were reviewed. Data analysis was performed between July 1, 2015, and December 31, 2015. The mean corrected distance visual acuity (CDVA), safety, stability of refraction, predictability of IOL power calculation, and postoperative complications were recorded.

Results 

The study comprised 38 eyes (29 patients). Of the eyes, 32 (82%) were within ±1.00 diopter (D) of the target refraction and 21 (57.9%) were within ±0.50 D. The mean CDVA after IOL implantation was significantly better than before pIOL implantation (P < .001) and similar to after pIOL implantation (P = .87). The safety of this multistepped procedure was good; on average, 1.6 Snellen lines of CDVA were gained over before pIOL implantation. Branch retinal vein occlusion occurred in 1 eye; no other sight-threatening complications were observed. Posterior capsule opacification developed in 15 eyes (39.5%) and was treated successfully with neodymium:YAG capsulotomy.

Conclusions 

The highest mean CDVA was recorded at the final visit. Good safety, stability, and predictability were also observed. Postoperative complications were few and in all but 1 case, not sight threatening. Overall, results indicate the combination of procedures does not negatively affect the final visual outcome.