Incidence rate and occurrence of visually significant cataract formation and corneal decompensation after implantation of Verisyse/Artisan phakic intraocular lens
A 35-year-old man with a history of right retinal detachment, repaired with scleral buckle 20 years ago, presented to the Moran Eye Center in 2000 desiring correction for severe myopia. A Verisyse pIOL was implanted in the left eye as part of the Verisyse FDA clinical trial. Preoperative endothelial cell density in the left eye was 2,146 cells/mm2. Three years later, a Verisyse pIOL was implanted in the right eye for myopia, with preoperative right SE of −15.125 and preoperative endothelial cell density of 2,053 cells/mm2. Postoperative right uncorrected distance visual acuity (UDVA) was 20/20. Ten years later, the patient developed cloudy vision in the right eye with CDVA of 20/30−. Slit-lamp examination identified corneal edema in the right eye. Right endothelial cell density was 1,364 cells/mm2. The patient was medically managed with prednisolone acetate 1% eyedrops, Muro® 128 5% eyedrops (Bausch and Lomb, Rochester, NY, USA) and ointment for 6 months, with improvement of vision. However, after 2 years, the patient’s vision worsened to counting fingers, correctable only to 20/100. Slit-lamp examination identified increasing corneal edema () and early nuclear sclerosis. The patient underwent explantation of the pIOL, cataract extraction with placement of PCIOL, and Descemet’s stripping automated endothelial keratoplasty (DSAEK). At the most recent examination, 4 weeks after surgery, the cornea was clear centrally, in the area of the DSAEK graft, with remaining peripheral corneal edema. The right eye CDVA was 20/25, and SE was +1.125.