Iris-Claw Anterior Chamber Phakic Intraocular Lens Explantation: A Case Series

Purpose: To evaluate indications, clinic characteristics, and outcomes in a series of patients who underwent explantation of phakic intraocular lens (pIOL). Methods: Retrospective case series of patients who underwent iris-claw pIOL explantation in our institution from 2018 to 2022. Indications for explantation and visual and refractive outcomes were analyzed. Results: Twenty-three eyes of 14 patients underwent pIOL explantation with a mean time to explantation of 11.7 ± 3.4 years. The mean age at explantation was 46.0 ± 3.9 years. Sixteen Artisan and seven Artiflex IOL were explanted. The main indication for explantation was endothelial cell loss (n = 14) and morphometric significant alterations of endothelial cells other than endothelial cell count decline (n = 5). The mean corrected vision after explantation was 0.4 ± 0.4 logMAR, and around 70% of intervened patients achieved visual acuity of at least 0.3 logMAR (0.5 in decimal scale). Conclusions: In our group series, the main reason for the removal of pIOL was endothelial cell loss. This complication should be monitored and followed, so that early actions, namely IOL explantation, can be performed to avoid the development of deterioration requiring corneal transplantation. In fact, loss of follow-up, found in several cases for many years, continues to be a serious problem.