Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.
Cornea. 2011 Sep;30(9):1045-7. doi: 10.1097/ICO.0b013e3182035dd0.
To describe 2 cases of corneal decompensation after iris-fixated phakic intraocular lens (pIOL) implantation requiring Descemet stripping automated endothelial keratoplasty (DSAEK).
Case reports and literature review.
Two cases of corneal decompensation after pIOL implantation are reported. The average age at presentation was 52 years (range: 37 to 67 years) in 2 women. The mean presentation time of corneal decompensation after pIOL implantation was 29 months (range: 22 to 36 months). Both the affected eyes required pIOL explantation and DSAEK to treat corneal decompensation. One patient (1 eye) had concurrent cataract surgery to maximize visual rehabilitation. The mean follow-up after DSAEK surgery was 14 months (range: 12 to 16 months). The best-corrected visual acuity was 20/50 (range: 20/40 to 20/60) at the last follow-up.
Despite a good safety profile for iris-fixated pIOLs, some patients may still develop corneal decompensation after implantation. We report a pair of cases with corneal decompensation severe enough to warrant endothelial transplantation and pIOL explantation, with and without concomitant cataract surgery.
描述 2 例虹膜固定型有晶状体眼人工晶状体（pIOL）植入术后角膜失代偿，需要进行撕囊的自动化内皮角膜移植术（DSAEK）。
病例报告和文献复习。
报告了 2 例 pIOL 植入术后角膜失代偿的病例。2 例均为女性，平均年龄为 52 岁（范围：37 岁至 67 岁）。pIOL 植入术后角膜失代偿的平均出现时间为 29 个月（范围：22 个月至 36 个月）。2 只受累眼均需要行 pIOL 摘除和 DSAEK 以治疗角膜失代偿。其中 1 例（1 只眼）同时行白内障手术以最大限度地提高视力恢复。DSAEK 手术后的平均随访时间为 14 个月（范围：12 个月至 16 个月）。末次随访时最佳矫正视力为 20/50（范围：20/40 至 20/60）。
尽管虹膜固定型 pIOL 的安全性良好，但部分患者在植入后仍可能发生角膜失代偿。我们报告了 2 例角膜失代偿严重的病例，需要进行内皮移植和 pIOL 摘除，其中 1 例联合白内障手术。
