Prototype posterior chamber phakic IOL - 35 year follow up.

Am J Ophthalmol Case Rep

First Department of Ophthalmology, National and Kapodistrian University of Athens, "G. Gennimatas" General Hospital of Athens, Greece.

Published: September 2024

AI Article Synopsis

  • - A 64-year-old man with bilateral cataracts and a 35-year-old prototype posterior chamber phakic IOL (PC-pIOL) experienced poor vision, prompting surgical intervention.
  • - After successful extraction of the PC-pIOL and vitrectomy on the right eye, the patient's vision improved significantly to 20/25 one month post-surgery, while the left eye was managed conservatively.
  • - This case highlights the uncommon clinical properties of a long-implanted IOL and shows that leaving the patient aphakic (without an intraocular lens) can be an effective treatment option.

Article Abstract

Purpose: To present a case involving a rarely seen prototype posterior chamber phakic IOL (PC-pIOL) in a highly myopic patient with bilateral cataract.

Observations: A 64-year-old male presented to our clinic with poor vision in both eyes. Clinical examination revealed bilateral mature cataract, phacodonesis as well as a PC-pIOL implanted 35 years ago to address his high myopia. The visual acuity (VA) was 20/200 in the right eye and no light perception in the left eye. PC-pIOL extraction as well as 23G pars plana vitrectomy (PPV) and fragmentation surgery was scheduled for the right eye. The left eye was treated conservatively. Successful extraction of the PC-pIOL was performed while it was easy to remove. It was a bow-tie shaped lens with a collar-stud-like button in the middle which extended anteriorly into the anterior chamber through the pupil. PPV with lens fragmentation was successful and the patient was left aphakic in order to avoid the placement of a zero diopter IOL. Final best corrected VA was 20/25 one month post-surgery.

Conclusions And Importance: Removal of this rarely seen pIOL was performed without difficulty while excellent VA was achieved. Aphakia following complete vitrectomy represented a viable option in this case. Furthermore, we highlight the clinical manifestations associated with this IOL more than three decades after implantation.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11200273PMC
http://dx.doi.org/10.1016/j.ajoc.2024.102086DOI Listing

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