Analysis Of Causes Of Anterior Chamber Intraocular Lens Explantation

Objective:With the wide application of anterior chamber intraocular lenses in ophthalmic surgeries for decades, its complications have drawn attention of many ophthalmologists nowadays. We performed this study to analyze and summarize the causes of anterior chamber intraocular lens extractions.Materials and Methods:40cases of anterior chamber intraocular lenses extractions performed in Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine in the past7years were analyzed retrospectively. Extraction causes of phakic intraocular lenses and aphakic intraocular lenses were summarized separately. Pre-surgery intra-ocular pressure and post-surgery intra-ocular pressure were compared using wilcoxon rank sum test, what’s more, the correlation between best corrected visual acuity and corneal endothelial cell density、standard deviation and percentage of hexagonal cells of the cells marked were also assessed using SPSS software.Results:Two groups of cases were distinguished:15cases that had phakic anterior chamber intraocular lenses explanted and25cases that had aphakic anterior chamber intraocular lenses explanted. Main causes of lenses explanations were corneal endothelial decompensation (47.5%), secondary glaucoma (7.5%), complicated cataract (7.5%), dislocation of intraocular lenses (12.5%), secondary glaucoma complicated with corneal endothelial decompensation (12.5%) and others (12.5%). The top three causes of phakic intraocular lenses explantations were corneal endothelial decompensation (73.3%), complicated cataract (20%), secondary glaucoma complicated with corneal endothelial decompensation (6.7%). On the other hand, corneal endothelial decompensation (32%), dislocation of intraocular lenses (20%), secondary glaucoma complicated with corneal endothelial decompensation (16%) were the three main causes of aphakic intraocular lenses explantations. Pupil ovalization incidence of phakic cases was46.7%. The pre-explantation intra-ocular pressure was23.8±14.5mmHg, which is significantly higher than post-surgery intra-ocular pressure (16.8±9.8mmHg). Besides, best corrected visual acuity of phakic cases was strikingly correlated to cornea endothelial standard deviation.Conclusions:Corneal endothelial decompensation was the main cause of explantations for both phakic and aphakic anterior chamber intraocular lenses. Explantation of anterior chamber intraocular lenses could lead to significant reduction of intra-ocular pressure. Pre-surgery best corrected visual acuity was associated to corneal endothelial standard deviation, which can be used to indicate the prognosis of corneal endothelial decompensation.