Prototype posterior chamber phakic IOL - 35 year follow up.

Area of Science:

• Ophthalmology
• Intraocular Lens Technology
• Surgical Case Reports

Background:

• Presents a rare case of a prototype posterior chamber phakic intraocular lens (PC-pIOL) implanted 35 years ago.
• Addresses management challenges in a highly myopic patient with bilateral mature cataracts and phacodonesis.

Observation:

• A 64-year-old male with a 35-year-old PC-pIOL presented with severe vision loss (20/200 OD, NLP OS).
• The unique, bow-tie shaped PC-pIOL with an anteriorly extending component was successfully extracted.
• Pars plana vitrectomy (PPV) with lens fragmentation was performed on the right eye, leaving the patient aphakic.

Findings:

• The rare PC-pIOL was removed without difficulty.
• Post-operative aphakia following PPV was a successful management strategy.
• Excellent final corrected visual acuity of 20/25 was achieved in the operated eye one month post-surgery.

Implications:

• Highlights the long-term clinical manifestations and management of rare, older-generation phakic intraocular lenses.
• Demonstrates that aphakia after complete vitrectomy is a viable alternative to IOL implantation in complex cases.
• Provides insights into the surgical removal of long-implanted, unusual intraocular lens designs.