Pathological examination of an explanted phakic posterior chamber intraocular lens

To report the clinicopathological correlation of an explanted phakic posterior chamber intraocular lens (PPC IOL) and to study the conformation of this lens implanted into human eyes obtained postmortem.

Center for Research on Ocular Therapeutics and Biodevices, Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.

Three silicone PPC IOLs were explanted. One lens, explanted from a 38-year-old woman with complicated cataract, was submitted for pathological analysis. In addition to gross and scanning electron microscopy (SEM), the lens was studied after experimental implantation in human eyes obtained postmortem using frontal, posterior, and side-view techniques.

Although gross and SEM showed that the IOL was well polished, examination of the lens in human cadaver eyes showed it was oversized and poorly fixated. It was relatively bulky in its anterior-posterior dimension and revealed evidence of significant contact with the iris and crystalline lens.

This study illustrates many pitfalls to be avoided in the design of a plate PPC IOL. The lens in this report was too large, and instead of ciliary sulcus fixation, it showed poor fixation through the zonules onto the posterior face of the pars plicata. Present and future PPC IOLs should be submitted for similar preclinical studies to clarify the type and site of fixation.