Outcomes of Phakic IOL Exchange
Narrative Responses:
Purpose
To describe the clinical outcomes in a series of patients with high post operative vaults and subsequent phakic intraocular lens (pIOL) exchange.
Methods
This is a retrospective, interventional case series. 2 eyes of 2 patients who had high post-operative vaults were included in the study. Clinical outcomes on serial follow-up of pIOL exchange using the contralateral eye as control were analyzed. Outcome measures evaluated were the change in visual acuity (LOGMAR), change in visual quality (using the OPD 3, NIDEK) and change in the vault after ICL exchange. Safety measures analyzed were the intraocular pressure, angle changes on gonioscopy, endothelial cell density (ECD) using specular microscopy and lens densitometry changes using the Pentacam.
Results
A 0.5 mm reduction in the size of the exchanged ICL diameter resulted in a mean reduction of vault by 0.547 um. Baseline, pre and post-pIOLexchange corrected and uncorrected distance visual acuity and visual quality did not show any statistically significant difference. The alteration noted in the ECD after pIOL exchange was 125.5 cells/mm3. Mean ECD in the contralateral eye after using the undersized pIOL was 46 cells/mm3. No lens damage was evident from the stable lens density (Change: 0.3) on Pentacam at all follow up visits. IOP and angle evaluation did not show significant differences.
Conclusion
Horizontal white to white as a surrogate for the sulcus diameter resulted in high vault in 2 eyes requiring pIOL exchange. Exchange of pIOLs was safe and effective with clinical outcomes comparable to the contralateral eyes that did not require pIOL exchange.