Corneal endothelial decompensation after iris-claw phakic intraocular lens implantation

A 25-year-old man received iris-claw phakic intraocular lenses (pIOLs) (Artisan, Ophtec) of -11.5 diopters (D) in the right eye and -13.0 D in the left eye; both pIOLs had a 6.0 mm optic and 8.5 mm haptics. Twenty months postoperatively, the best corrected visual acuity was 20/400 in the right eye and 20/25 in the left eye. Slitlamp examination revealed microcystic bullae, keratic precipitates, stromal edema, and ciliary injection in both eyes. Central corneal thickness was 704 microm in the right eye and 639 microm in the left eye; specular biomicroscopy showed reduced endothelial cell density of 548 cells/mm(2) and 564 cells/mm(2), respectively. The pIOL in the right eye was eventually explanted.