Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy[phakic intraocular lens(plOL)explantation with cataract surgery and pseudophakic intraocular lens(IOL)implantation]in patients previously implanted with posterior chamber plOLs(PC plOLs).Methods:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for PC plOL with a follow-up time of 12 months.The uncorrected and corrected distance visual acuities(UDVA,CDVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative complications.Results:There was a statistically significant improvement in UDVA and CDVA after bilensectomy(P=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal edema.The endothelial cell count remained stable without a statistically significant change after surgery(P=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CDVA after surgery,73%of the patients were within±1.0D(spherical equivalent)of the target refraction.Intraoperative complications were one posterior capsule rupture with the IOL implanted in the sulcus,and three eyes required the use of pupil expanders for adequate pupil dilation.Postoperatively,one eye developed retinal detachment.The three plOLs models explanted were the implantable collamer lens(ICL);implantable phakic contact lens(IPCL)and the phakic refractive lens(PRL).Conclusions:Good safety and visual outcomes were observed one year after bilensectomy for PC plOLs.There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.