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Lens vacuoles during phakic intraocular lens implantation

Lens vacuoles during phakic intraocular lens implantation

Lens vacuoles during phakic intraocular lens implantation

Artículo original publicado en:
Journal of Emmetropia
Autores: Juan Gros-Otero, Inés Contreras-Martín, Jorge García-Pérez, Fran.

 

Abstract:

Lens damage during phakic intraocular lens implantation is a major complication. A case of a patient who developed lens vacuoles during toric implantable collamer lens (ICL) removal from her right eye and insertion of a new non-toric ICL due to persistent rotation of the former is presented in this work. As this event is very uncommon when implanting phakic intraocular lenses, the performed surgical procedure, the appearance of the vacuoles and the hypothesis on the origin of the vacuoles is described.

Refractive surgery with phakic intraocular lenses (pIOL) is a solution for young patients with clear lenses. The development of significant lens opacities after the insertion of these lenses are a complication that should be kept in mind. The incidence of cataractogenesis described after the implantation of posterior chamber pIOL ranges between 25.7% and 3.6% depending on the model of pIOL1. The suggested etiology for the development of cataracts are: intermittent contact between pIOL and the lens, operative trauma, insufficient lens nutrition and chronic subclinical inflammation. Anterior subcapsular cataracts are the most common type of cataract. These cataracts may either remain stable over time or lead to a reduction in visual acuity, and as such, these patients should undergo closer follow-up2.

The present work describes the case of a patient scheduled for the removal of a toric implantable collamer lens (ICL) from her right eye and the insertion of a new non-toric ICL due to the persistent rotation of the former. Reposition in accordance with the correct astigmatism axis was attempted twice, however, after both procedures, the ICL appeared to be misaligned in the days following. During the fourth surgical procedure, when the toric ICL was removed, vacuoles appeared on the surface of the patient´s lens. The surgical procedure performed and the evolution of the vacuoles is also described.

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