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Analysis of the causes leading to ICL explantation and exchange,and the surgical skills of ICL explantation

Session Details

Session Title: Phakic IOL Implantation II

Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30

Paper Time: 09:58

Venue: E104-105 (First Floor)

First Author: : Q.Zeng CHINA

Co Author(s): :    X. Xie   Y. Zhang   Q. Wang        

Abstract Details

Purpose:

To analyze the causes leading to the explantation and exchange of posterior chamber phakic intraocular lens implantation (ICL) as well as the surgical techniques of the exchange of ICL.

Setting:

Zheng Qingyan, Xie Xiuli, Zhang Ying, Wang Qifeng. Wuhan Aier Eye Hospital

Methods:

This retrospective study reviewed 15 eyes of 13 patients who were undergoing ICL exchange in Wuhan Aier Eye Hospital. We evaluated the causes leading to ICL exchange and surgical techniques including the incision selection in ICL exchange and the ICL explantation skills by comparing the cornea endothelia cells count, intraocular pressure (IOP), vaulting and crystalline transparency before and 11 months after ICL exchange surgery. SPSS 18.0 was used for statistical analysis.

Results:

In these 15 eyes undergoing ICL exchange, 4 eyes (27%) were due to low vaulting (?100um) and 11 eyes (83%) were due to high vaulting (?1000um). 2 out of the 4 low vaulting patients were over 40 years old and the crystalline thickness of 3 low vaulting eyes was more than 4.0mm. The reasons of high vaulting include oversized WTW by digital caliper and ciliary body vesicle. The mean cornea endothelia cell density (CEC) was 2832±378 /mm2, 2759±472/mm2 and 2718±353/mm2 before ICL surgery, before ICL exchange and after ICL exchange respectively. There was no significant statistical difference with the CEC before ICL surgery, before ICL exchange and after ICL exchange (P<0.01). At 11 months after ICL exchange, the vaulting was 334-678um. No vision threaten complications occurred during observational period.

Conclusions:

The main causes leading to abnormal vaulting then ICL exchange include WTW measurement error, cliary body vesicle, bigger crystalline and age over 40 years. ICL explantation should be designed with forceps clip on different part of ICL in terms of the vaulting to achieve good safety and efficacy.

Financial Interest:

NONE