[Cataract surgery in biphakia patients]

Although the IOL implantation was used initially just for cataract surgery, in the last period IOLs are used in treating myopia more than -12D and hyperopia more than +4D, in phakic eyes, when the indications of excimer laser are limited.

We present the case of a 40 years old patient with the diagnosis: biphakia, complicated cataract and high myopia in both eyes. VA-RE = 2/50 cc, VA-LE = 3/50 cc, IOP-RE:15 mmHg, IOP-LE:16 mmHg. We performed, in two separate surgeries, the explantation of the intraocular lens, then the extraction of the opacified crystalline lens through the same incision and the implantation of an AcrySof foldable lens with an adequate power, in the bag. We discuss the causes of cataract formation in eyes with posterior chamber phakic intraocular lens, the choice of the IOL power, the incision for explantation and implantation, and the intraoperative technical difficulties.

The association of phakic IOLs and cataract represents a new challenge to the ophthalmic surgeon, taking into account that these IOLs are becoming more and more popular to correct high refractive errors.