Risk factors for explantation of iris-fixated phakic intraocular lenses

Soraya M.R. Jonker (Corresponding author), Annelies A.C. Van Averbeke, Tos T.J.M. Berendschot, Isabelle E.Y. Saelens, Rudy M.M.A. Nuijts

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Abstract

Purpose To determine risk factors for explantation of iris-fixated phakic intraocular lenses (pIOLs) with a maximum 17-year follow-up. Setting University Eye Clinic Maastricht, Maastricht UMC+, the Netherlands. Design Prospective case series. Methods Eyes that had implantation of 1 of various iris-fixated pIOL models from 1998 to 2016 were evaluated. Primary outcome measures were the rate and proportion of pIOL explantations and the survival time (ie, time to pIOL explantation) in general and specifically as a result of cataract formation or endothelial cell loss (ECL). Results The study comprised 1037 eyes. The mean follow-up was 69.3 months ± 52.8 (SD) and the mean preoperative age, 40.2 ± 10.9 years. The overall explantation rate was 12% after a mean of 166.1 months ± 3.0 (standard error). Phakic IOL explantations were performed in 59% of eyes because of cataract formation and in 32% because of ECL. Shorter survival was seen with a higher preoperative age (hazard ratio [HR], 1.07/y; P < .001), longer axial length (AL) (HR, 1.10/mm; P = .009), and smaller anterior chamber depth (ACD) (HR, 4.47/mm; P < .001). Factors for shorter survival resulting from cataract were older preoperative age, longer AL, and larger ACD. Risk factors contributing to shorter survival resulting from ECL were a smaller ACD, lower endothelial cell density, and implantation with an Artisan hyperopia (toric) or Artiflex myopia (toric) IOL. Conclusions The explantation rate of iris-fixated pIOLs was 12% after almost 14 years of follow-up, with 59% of pIOL explantations caused by cataract formation and 32% caused by ECL. An older preoperative age, longer AL, and smaller ACD were risk factors for a shorter survival.
LanguageEnglish
Pages1092-1098
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume45
Issue number8
DOIs
StatePublished - Aug 2019

Cite this

Jonker, S. M. R., Van Averbeke, A. A. C., Berendschot, T. T. J. M., Saelens, I. E. Y., & Nuijts, R. M. M. A. (2019). Risk factors for explantation of iris-fixated phakic intraocular lenses. Journal of Cataract and Refractive Surgery, 45(8), 1092-1098. DOI: 10.1016/j.jcrs.2019.03.009
Jonker, Soraya M.R. ; Van Averbeke, Annelies A.C. ; Berendschot, Tos T.J.M. ; Saelens, Isabelle E.Y. ; Nuijts, Rudy M.M.A./ Risk factors for explantation of iris-fixated phakic intraocular lenses. In: Journal of Cataract and Refractive Surgery. 2019 ; Vol. 45, No. 8. pp. 1092-1098
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title = "Risk factors for explantation of iris-fixated phakic intraocular lenses",
abstract = "Purpose To determine risk factors for explantation of iris-fixated phakic intraocular lenses (pIOLs) with a maximum 17-year follow-up. Setting University Eye Clinic Maastricht, Maastricht UMC+, the Netherlands. Design Prospective case series. Methods Eyes that had implantation of 1 of various iris-fixated pIOL models from 1998 to 2016 were evaluated. Primary outcome measures were the rate and proportion of pIOL explantations and the survival time (ie, time to pIOL explantation) in general and specifically as a result of cataract formation or endothelial cell loss (ECL). Results The study comprised 1037 eyes. The mean follow-up was 69.3 months ± 52.8 (SD) and the mean preoperative age, 40.2 ± 10.9 years. The overall explantation rate was 12{\%} after a mean of 166.1 months ± 3.0 (standard error). Phakic IOL explantations were performed in 59{\%} of eyes because of cataract formation and in 32{\%} because of ECL. Shorter survival was seen with a higher preoperative age (hazard ratio [HR], 1.07/y; P < .001), longer axial length (AL) (HR, 1.10/mm; P = .009), and smaller anterior chamber depth (ACD) (HR, 4.47/mm; P < .001). Factors for shorter survival resulting from cataract were older preoperative age, longer AL, and larger ACD. Risk factors contributing to shorter survival resulting from ECL were a smaller ACD, lower endothelial cell density, and implantation with an Artisan hyperopia (toric) or Artiflex myopia (toric) IOL. Conclusions The explantation rate of iris-fixated pIOLs was 12{\%} after almost 14 years of follow-up, with 59{\%} of pIOL explantations caused by cataract formation and 32{\%} caused by ECL. An older preoperative age, longer AL, and smaller ACD were risk factors for a shorter survival.",
author = "Jonker, {Soraya M.R.} and {Van Averbeke}, {Annelies A.C.} and Berendschot, {Tos T.J.M.} and Saelens, {Isabelle E.Y.} and Nuijts, {Rudy M.M.A.}",
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Jonker, SMR, Van Averbeke, AAC, Berendschot, TTJM, Saelens, IEY & Nuijts, RMMA 2019, 'Risk factors for explantation of iris-fixated phakic intraocular lenses' Journal of Cataract and Refractive Surgery, vol. 45, no. 8, pp. 1092-1098. DOI: 10.1016/j.jcrs.2019.03.009

Risk factors for explantation of iris-fixated phakic intraocular lenses. / Jonker, Soraya M.R. (Corresponding author); Van Averbeke, Annelies A.C.; Berendschot, Tos T.J.M.; Saelens, Isabelle E.Y.; Nuijts, Rudy M.M.A.

In: Journal of Cataract and Refractive Surgery, Vol. 45, No. 8, 08.2019, p. 1092-1098.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Risk factors for explantation of iris-fixated phakic intraocular lenses

AU - Jonker,Soraya M.R.

AU - Van Averbeke,Annelies A.C.

AU - Berendschot,Tos T.J.M.

AU - Saelens,Isabelle E.Y.

AU - Nuijts,Rudy M.M.A.

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Y1 - 2019/8

N2 - Purpose To determine risk factors for explantation of iris-fixated phakic intraocular lenses (pIOLs) with a maximum 17-year follow-up. Setting University Eye Clinic Maastricht, Maastricht UMC+, the Netherlands. Design Prospective case series. Methods Eyes that had implantation of 1 of various iris-fixated pIOL models from 1998 to 2016 were evaluated. Primary outcome measures were the rate and proportion of pIOL explantations and the survival time (ie, time to pIOL explantation) in general and specifically as a result of cataract formation or endothelial cell loss (ECL). Results The study comprised 1037 eyes. The mean follow-up was 69.3 months ± 52.8 (SD) and the mean preoperative age, 40.2 ± 10.9 years. The overall explantation rate was 12% after a mean of 166.1 months ± 3.0 (standard error). Phakic IOL explantations were performed in 59% of eyes because of cataract formation and in 32% because of ECL. Shorter survival was seen with a higher preoperative age (hazard ratio [HR], 1.07/y; P < .001), longer axial length (AL) (HR, 1.10/mm; P = .009), and smaller anterior chamber depth (ACD) (HR, 4.47/mm; P < .001). Factors for shorter survival resulting from cataract were older preoperative age, longer AL, and larger ACD. Risk factors contributing to shorter survival resulting from ECL were a smaller ACD, lower endothelial cell density, and implantation with an Artisan hyperopia (toric) or Artiflex myopia (toric) IOL. Conclusions The explantation rate of iris-fixated pIOLs was 12% after almost 14 years of follow-up, with 59% of pIOL explantations caused by cataract formation and 32% caused by ECL. An older preoperative age, longer AL, and smaller ACD were risk factors for a shorter survival.

AB - Purpose To determine risk factors for explantation of iris-fixated phakic intraocular lenses (pIOLs) with a maximum 17-year follow-up. Setting University Eye Clinic Maastricht, Maastricht UMC+, the Netherlands. Design Prospective case series. Methods Eyes that had implantation of 1 of various iris-fixated pIOL models from 1998 to 2016 were evaluated. Primary outcome measures were the rate and proportion of pIOL explantations and the survival time (ie, time to pIOL explantation) in general and specifically as a result of cataract formation or endothelial cell loss (ECL). Results The study comprised 1037 eyes. The mean follow-up was 69.3 months ± 52.8 (SD) and the mean preoperative age, 40.2 ± 10.9 years. The overall explantation rate was 12% after a mean of 166.1 months ± 3.0 (standard error). Phakic IOL explantations were performed in 59% of eyes because of cataract formation and in 32% because of ECL. Shorter survival was seen with a higher preoperative age (hazard ratio [HR], 1.07/y; P < .001), longer axial length (AL) (HR, 1.10/mm; P = .009), and smaller anterior chamber depth (ACD) (HR, 4.47/mm; P < .001). Factors for shorter survival resulting from cataract were older preoperative age, longer AL, and larger ACD. Risk factors contributing to shorter survival resulting from ECL were a smaller ACD, lower endothelial cell density, and implantation with an Artisan hyperopia (toric) or Artiflex myopia (toric) IOL. Conclusions The explantation rate of iris-fixated pIOLs was 12% after almost 14 years of follow-up, with 59% of pIOL explantations caused by cataract formation and 32% caused by ECL. An older preoperative age, longer AL, and smaller ACD were risk factors for a shorter survival.

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SP - 1092

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JO - Journal of Cataract and Refractive Surgery

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SN - 0886-3350

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Jonker SMR, Van Averbeke AAC, Berendschot TTJM, Saelens IEY, Nuijts RMMA. Risk factors for explantation of iris-fixated phakic intraocular lenses. Journal of Cataract and Refractive Surgery. 2019 Aug;45(8):1092-1098. Available from, DOI: 10.1016/j.jcrs.2019.03.009