Creeping posterior synechiae following hyperopic iris-fixated phakic implants

Area of Science:

• Ophthalmology
• Surgical Innovation
• Intraocular Lenses

Background:

• Iris-fixated anterior chamber phakic IOLs are effective for correcting ametropia.
• Hyperopic eyes present unique considerations for IOL implantation.
• Posterior synechiae (PS) and pigment dispersion are potential complications.

Observation:

• Three hyperopic eyes developed PS and pigment dispersion 4-6 weeks post-surgery.
• Initial treatment with synechiolysis and pupil stretching was unsuccessful due to recurrence.
• All three patients underwent IOL explantation and phacoemulsification with intraocular lens implantation.

Findings:

• Iris-fixated phakic IOL implantation can lead to PS in hyperopic eyes.
• PS may be more prevalent in hyperopic eyes compared to myopic eyes.
• Age could be a contributing factor to PS development.

Implications:

• This case report highlights the risk of PS with iris-fixated phakic IOLs in hyperopic patients.
• Careful patient selection and pre-operative counseling are crucial.
• Alternative surgical strategies may be necessary for managing hyperopia in certain patients.