Anterior subcapsular cataract caused by forceful irrigation in implantation of a posterior chamber phakic implantable collamer lens with a central hole

Session Details

Session Title: Phakic IOLs

Session Date/Time: Monday 09/10/2017 | 08:30-10:20

Paper Time: 09:37

Venue: Meeting Center Room I

First Author: : T.Kohnen GERMANY

Co Author(s): :    G. Steinwender   K. Varna-Tigka   M. Shajari              

Abstract Details

Purpose:

To report the rare entity of anterior subcapsular cataract after implantation of a posterior chamber phakic implantable collamer lens (ICL) with a central hole.

Setting:

Department of Ophthalmology, Goethe-University, Frankfurt, Germany.

Methods:

In this retrospective case series, medical reports were reviewed of patients with vision loss due to anterior subcapsular cataract (ASC) after implantation of the V4c Visian ICL phakic intraocular lens (pIOL) with a central artificial hole. Patients were identified during regular follow-up visits between January and September 2015. Possible causative factors such as microbial contamination of surgical instruments, type of ophthalmic viscosurgical device (OVD) and irrigation substance, intracameral application of mydriatics and antibiotics, duration of surgeries, and surgical technique were analyzed.

Results:

Eleven eyes of 8 patients showed whitish opacification behind the anterior capsule of the crystalline lens 1 day postoperatively. In all eyes opacification led to a significant loss of corrected distance visual acuity (CDVA). In 9 eyes the pIOL was explanted and in 8 eyes phacoemulsification and IOL implantation was performed. As all other analyzed possible causative factors were excluded, the opacification was attributed to the surgical technique of OVD removal by irrigation with a cannula in the presence of a central hole in the pIOL. After adapting surgical technique no further cases of ASC occurred.

Conclusions:

Anterior subcapsular cataract can be induced by the surgical technique of OVD removal in the implantation of the V4c Visian ICL pIOL with a central hole. The opacification was attributed to the cannula irrigation with enforced stream onto the capsule through the central port. This entity can be avoided completely by a change in surgical technique.

Financial Disclosure:

gains financially from product or procedure presented, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a competing company, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented