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To describe the causes of extraction of iris fixated phakic intraocular lenses (pIOLs) Artisan-Artiflex.
In this retrospective single center study, we reviewed 253 eyes of 176 patients underwent pIOLs (Artisan-Artiflex) implantation at Instituto de Ojos Oftalmosalud from 2001 to 2019. The parameters evaluated were percentage of lens extractions, differentiated by causes and the pIOL survival time. Anterior chamber morphometrics were also analyzed retrospectively as well as other parameters (age, sex, endothelial cell count, peripheral endothelial-lens distance, pIOL power and model).
A total of 35 pIOLs had to be explanted (13.8%) after a mean of 12.18 +/-3.9 (SD) years. Cataract formation was the main cause of extraction in 62.9% (22) of the cases. Corneal transplant, because of corneal decompensation, was needed in 28.6% (10) of the cases. High intraocular pressure alone was the cause of extraction in 2.86% (1). The mean distance between the peripheral edge of the pIOL and the endothelium in eyes without pIOL extraction was 1.41mm (SD+/-0.27); a significant smaller distance was found in eyes with pIOL extraction 1.12mm (+/-0.35) (P < 0.001), and in eyes with pIOL extraction and corneal decompensation that required a corneal transplant 0.77mm (+/-0.41).
The mean survival time of the pIOLs was 12.18 +/- 3.9 years. ECL was present in almost all of the cases of extraction. Cataract formation was the main cause followed by corneal decompensation. We believe a small E-L (endothelial-lens) distance could be a good predictor of ECL and corneal decompensation.