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Christian Hofmann, Thomas Kohnen; Severe Loss Of Endothelial Cell Density And Beginning Corneal Decompensation 6 Years After Implantation Of I-CARE Anterior-Chamber Angle-Supported Phakic Intraocular Lens. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6216.
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To report on a case of severe loss of endothelial cell density (ECD) and beginning corneal decompensation 6 years after implantation of I-CARE anterior-chamber angle-supported phakic intraocular lens (IOL).
Measurement of ECD, imaging of anterior segment optical coherence tomography (OCT)/ scheimpflug and slit lamp photography were performed on a 29 year old patient six years after implantation of I-CARE phakic IOL. Measurement of ECD and slit lamp photography were performed one day and one week after surgical explantation that was video taped.
Initially, 2 months after IOL-implantation, ECD values were 2,551/mm² (oculus dexter [OD]) and 3,058/mm² (oculus sinister [OS]). Six years later ECD values were 1,283/mm² (OD) and 2,283/mm² (OS). The anterior chamber OCT showed an anteriorly located IOL on OD, touching the endothelium on two places, and a regularly located IOL on OS. By the slit lamp a beginning corneal decompensation could be seen as well as an ovalized and stretched pupil on OD. OS showed both a regular IOL-localization and a regular anterior segment. One day after explantation of the IOL on OD, ECD value was 791/mm². One week post-surgically ECD value was 676/mm² on OD. The pupil was still residually ovalized. Intraocular pressure was 19 mmHg. The patient is scheduled for follow up and for IOL explantation on OS as well as consecutive refractive lens exchange on both eyes on long term.
I-CARE anterior-chamber angle-supported phakic intraocular lens can result in a severe loss of ECD and beginning corneal decompensation and may require surgical explantation in order to prevent from loss of vision and potential keratoplasty.
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