Cataract development associated with collagen copolymer posterior chamber phakic intraocular lenses: clinicopathological correlation.

PURPOSE

To assess the histopathology of anterior subcapsular cataract associated with a collagen copolymer posterior chamber phakic intraocular lens (pIOL) (Visian Implantable Collamer Lens) using light microscopy after pIOL explantation and cataract surgery.

SETTING

John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

DESIGN

Laboratory investigation.

METHODS

Pathology specimens related to explanted pIOLs were reviewed and preoperative and postoperative patient data collected. The anterior lens capsules and explanted pIOLs were examined.

RESULTS

Four eyes (3 patients) had pIOL explantation for low vault and anterior subcapsular cataract. The explanted pIOLs were the shorter length models (3, 12.1 mm; 1, 12.6 mm). Anterior segment optical coherence tomography (AS-OCT) confirmed the low pIOL vault before explantation in 2 eyes. Histopathology of the anterior subcapsular cataract showed fibrous metaplasia with a variable number of lens epithelial cell (LEC) layers attached to the inner surface of the anterior capsulorhexis specimens. Light microscopy of the explanted pIOLs showed no pigment on 1 lens, mild pigment deposition on 1 haptic, and pigment deposition throughout the anterior surface of 2 pIOLs.

CONCLUSIONS

Anterior subcapsular cataract associated with the pIOLs was caused by low vaulting (confirmed on AS-OCT) and consequent fibrous metaplasia of the anterior LECs. Surgeons should consider the possibility of anterior subcapsular cataract associated with shorter platforms when selecting a pIOL length for appropriate vault.