title: Phakic intraocular lens explantation: causes in 240 cases.
abstract: OBJECTIVE
  To describe the main causes of explantation of phakic intraocular lenses (PIOLs) according to the anatomical site of implantation (angle supported, iris fixated, or posterior chamber).
  
  
  METHODS
  This multicentric, retrospective, and consecutive study sponsored by the Spanish Ministry of Health comprised a total of 240 eyes (226 patients) explanted due to PIOL complications. Clinical data of 144 angle-supported lenses, 24 iris-fixated lenses, and 72 posterior chamber lenses explanted were recorded preoperatively and postoperatively.
  
  
  RESULTS
  Mean age of the patients at explantation was 46.30 ± 11.84 years (range: 25 to 80 years). The mean time between implantation and explantation was 381.14 ± 293.55 weeks (range: 0.00 to 1,551.17 weeks). It was 422.33 ± 287.81 weeks for the angle-supported group, 488.03 ± 351.95 weeks for the iris-fixated group, and 234.11 ± 4,221.60 weeks for the posterior chamber group. It was 8.10 ± 5.52 years for the angle-supported group, 9.36 ± 6.75 years for the iris-fixated group, and 4.49 ± 4.25 years for the posterior chamber group. This period of time was significantly shorter in the posterior chamber group (P < .001). Overall, the main causes of explantation were cataract formation (132 eyes, 55%), endothelial cell loss (26 eyes, 10.83%), corneal decompensation (22 eyes, 9.17%), PIOL dislocation/decentration (16 eyes, 6.67%), inadequate PIOL size or power (12 eyes, 5%), and pupil ovalization (10 cases, 4.17%). Cataract development was the cause of explantation in 51.39% of angle-supported cases, 45.83% of iris-fixated cases, and 65.28% of posterior chamber cases. Endothelial cell loss was the cause of explantation in 15.97% of angle-supported PIOLs, 8.33% of iris-fixated PIOLs, and 1.39% of posterior chamber PIOLs.
  
  
  CONCLUSIONS
  Cataract is the main cause of PIOL explantation, especially in posterior chamber PIOLs. In the angle-supported group, endothelial cell loss was the second cause of explantation.
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: Bader T
authors.initials: BT
authors.lastname: Toffaha
authors.forename: Pablo
authors.initials: P
authors.lastname: Peña-Garcia
authors.forename: Luis Manuel
authors.initials: LM
authors.lastname: Sádaba
authors.forename: Rafael I
authors.initials: RI
authors.lastname: Barraquer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications* / Q000473:pathology; D005901:Glaucoma / Q000150:complications; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000601:surgery*; D054120:Phakic Intraocular Lenses / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D012030:Refractive Errors; D012163:Retinal Detachment / Q000150:complications; D012189:Retrospective Studies; D012720:Severity of Illness Index