Alió Jorge L, Toffaha Bader T, Peña-Garcia Pablo, Sádaba Luis Manuel, Barraquer Rafael I
J Refract Surg. 2015 Jan;31(1):30-5. doi: 10.3928/1081597X-20141202-01. Epub 2014 Dec 9.
To describe the main causes of explantation of phakic intraocular lenses (PIOLs) according to the anatomical site of implantation (angle supported, iris fixated, or posterior chamber).
This multicentric, retrospective, and consecutive study sponsored by the Spanish Ministry of Health comprised a total of 240 eyes (226 patients) explanted due to PIOL complications. Clinical data of 144 angle-supported lenses, 24 iris-fixated lenses, and 72 posterior chamber lenses explanted were recorded preoperatively and postoperatively.
Mean age of the patients at explantation was 46.30 ± 11.84 years (range: 25 to 80 years). The mean time between implantation and explantation was 381.14 ± 293.55 weeks (range: 0.00 to 1,551.17 weeks). It was 422.33 ± 287.81 weeks for the angle-supported group, 488.03 ± 351.95 weeks for the iris-fixated group, and 234.11 ± 4,221.60 weeks for the posterior chamber group. It was 8.10 ± 5.52 years for the angle-supported group, 9.36 ± 6.75 years for the iris-fixated group, and 4.49 ± 4.25 years for the posterior chamber group. This period of time was significantly shorter in the posterior chamber group (P < .001). Overall, the main causes of explantation were cataract formation (132 eyes, 55%), endothelial cell loss (26 eyes, 10.83%), corneal decompensation (22 eyes, 9.17%), PIOL dislocation/decentration (16 eyes, 6.67%), inadequate PIOL size or power (12 eyes, 5%), and pupil ovalization (10 cases, 4.17%). Cataract development was the cause of explantation in 51.39% of angle-supported cases, 45.83% of iris-fixated cases, and 65.28% of posterior chamber cases. Endothelial cell loss was the cause of explantation in 15.97% of angle-supported PIOLs, 8.33% of iris-fixated PIOLs, and 1.39% of posterior chamber PIOLs.
Cataract is the main cause of PIOL explantation, especially in posterior chamber PIOLs. In the angle-supported group, endothelial cell loss was the second cause of explantation.
根据有晶状体眼人工晶状体（PIOL）的植入解剖部位（房角支撑型、虹膜固定型或后房型）描述其取出的主要原因。
这项由西班牙卫生部资助的多中心、回顾性、连续性研究共纳入了240只因PIOL并发症而取出的眼（226例患者）。记录了144只房角支撑型人工晶状体、24只虹膜固定型人工晶状体和72只后房型人工晶状体取出术前和术后的临床数据。
取出时患者的平均年龄为46.30±11.84岁（范围：25至80岁）。植入与取出之间的平均时间为381.14±293.55周（范围：0.00至1551.17周）。房角支撑型组为422.33±287.81周，虹膜固定型组为488.03±351.95周，后房型组为234.11±4221.60周。房角支撑型组为8.10±5.52年，虹膜固定型组为9.36±6.75年，后房型组为4.49±4.25年。后房型组的这段时间明显更短（P<.001）。总体而言，取出的主要原因是白内障形成（132只眼，55%）、内皮细胞丢失（26只眼，10.83%）、角膜失代偿（22只眼，9.17%）、PIOL脱位/偏中心（16只眼，6.67%）、PIOL尺寸或屈光度不合适（12只眼，5%）以及瞳孔椭圆化（10例，4.17%）。白内障发展是51.39%的房角支撑型病例、45.83%的虹膜固定型病例和65.28%的后房型病例取出的原因。内皮细胞丢失是15.97%的房角支撑型PIOL、8.33%的虹膜固定型PIOL和1.39%的后房型PIOL取出的原因。
白内障是PIOL取出的主要原因，尤其是在后房型PIOL中。在房角支撑型组中，内皮细胞丢失是取出的第二个原因。
