Nuclear cataract, moderate oblique corneal astigmatism, and glaucoma in a highly myopic eye implanted with a foldable iris-fixated phakic IOL. Issue 11 (November 2021)

• Record Type: Journal Article
• Authors: Menapace, Rupert
• Is Part Of: Journal of cataract and refractive surgery. Volume 47:Issue 11(2021)
• Page Start: 1487
• Page End: 1487
• Publication Date: 2021-11
• Subjects: 617.7
• DOI: 10.1097/j.jcrs.0000000000000835
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : A 65-year-old woman presents with nuclear cataract, moderate oblique corneal astigmatism, and glaucoma in a highly myopic eye previously implanted with a foldable iris-fixated phakic IOL. Abstract : A 65-year-old woman had undergone bilateral foldable iris-fixated phakic intraocular lens (pIOL) implantation in 2008 to correct for high myopia of −10 diopters (D). 12 years later, she presented with nuclear and subcortical cataract in her right eye. The Artiflex pIOL (Figure 1 ) was well centered and fixed to the iris. Endothelial cell count (ECC) was 2159 per mm 2 and corneal thickness 515 µm. Residual correction in her distance glass was −1.75 + 1.5 × 60. Topography showed a symmetric bowtie with a mean simulated keratometry of 1.3 D at an axis of 67 degrees (Figure 2 ). Keratometry was 1.5 @ 65. Left eye refraction was −1.5 + 1.0 × 175. The patient had also developed chronic open-angle glaucoma with intraocular pressure measurements exceeding 30 mm Hg, which was currently regulated with topical medication. What would be your surgical approach for cataract surgery with IOL removal and replacement when also considering the possible later need for superior glaucoma filtering surgery?