Severe endothelial cell loss following uneventful angle-supported phakic intraocular lens implantation for high myopia.
Endothelial decompensation is a serious complication of phakic intraocular lens (pIOL) implantation and is a major concern during the postoperative period. We report 3 eyes in which the same foldable angle-supported pIOL was implanted to correct high myopia. Rapid and severe postoperative endothelial cell loss occurred in all 3 eyes. An over-sized pIOL that induced excessive vaulting into the anterior chamber was the main risk factor. In 2 eyes, the pIOL was explanted uneventfully; 1 eye required Descemet's stripping automated endothelial keratoplasty because of total endothelial decompensation. These cases illustrate the importance of accurate sizing of foldable angle-supported anterior chamber pIOLs to avoid excessive vaulting. They also highlight the importance of regular follow-up and preventive pIOL explantation as soon as significant endothelial cell loss is detected.
Department of Ophthalmology, Purpan Hospital, Toulouse, France. coullet.j@chu-toulouse.fr
Julien
J
Coullet
Laurence
L
Mahieu
François
F
Malecaze
Pierre
P
Fournié
Audrey
A
Leparmentier
Solange
S
Moalic
Jean-Louis
JL
Arné
D000867:Anterior Chamber / Q000000981:diagnostic imaging / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007908:Lens, Crystalline / Q000502:physiology*; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications