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. 2014 Apr 18;7(2):376-80.
doi: 10.3980/j.issn.2222-3959.2014.02.32. eCollection 2014.

Long-term vision-threatening complications of phakic intraocular lens implantation for high myopia

Isil Bahar Sayman Muslubas  1 , Baran Kandemir  2 , Ayse Yesim Aydin Oral  2 , Suleyman Kugu  2 , Metin Dastan  3
Affiliations

Long-term vision-threatening complications of phakic intraocular lens implantation for high myopia

Isil Bahar Sayman Muslubas et al. Int J Ophthalmol. .

Abstract

Aim: To report the long-term vision-threatening complications in patients who underwent phakic intraocular lens (pIOLs) implantation for high myopia.

Methods: This study was designed from a consecutive series of phakic intraocular lens complication and corrective surgeries. Sixteen eyes of 13 patients had implantation of phakic intraocular lens for correction high myopia and developed serious complications have been included in this study. The mean age of patients was 38.6±6.35y (range 32-50y) and the mean time of history of pIOL implantation for high myopia was 6±2y (range 2-10y). Before corrective surgery, best spectacle-corrective visual acuity (BSCVA) ranged from perception to 20/200 in the eyes in which severe complications occurred.

Results: Corneal decompensation occurred in 12 eyes of 9 high myopic patients after anterior chamber pIOL implantation. Rhegmatogenous retinal detachment (RRD) occurred in 4 eyes of 4 high myopic patients following anterior chamber and posterior chamber pIOL implantation. Patients with corneal decompensation, had combined procedures consisting of pIOL removal and penetrating keratoplasty (PKP). Removals of pIOL, phacoemulsification and pars plana vitrectomy (PPV) with silicone oil tamponade were performed in patients with RRD. After corrective surgeries, all patients but one (P+, patient 2, right eye) achieved moderate BSCVA ranged from 20/200 to 20/50 at the last visit.

Conclusion: Phakic IOLs may be effective for the correction of high myopia. Although these IOLs may have severe complications and it affects safety and efficacy of this surgery. As seen here, corneal decompensation and rhegmatogenous retinal detachment are possible postoperative vision-threatening complications of phakic IOLs. Patients must be carefully examined before and after surgery for possible endothelial cell loss and vitreoretinal problems.

Keywords: complications; corneal decompensation; high myopia; phakic intraocular lens; rhegmatogenous retinal detachment.

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Figures

Figure 1
Figure 1. Patient 4, left eye.
Figure 2
Figure 2. Patient 9, after corrective surgery.
Figure 3
Figure 3. Patient 2, right eye.
See this image and copyright information in PMC

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