Exchange of a posterior chamber phakic intraocular lens in a highly myopiceye

A 38-year-old woman had posterior chamber phakic intraocular lens (IOL) imp lantation as a secondary refractive procedure to correct residual refractio n (20/50 with - 16.50 - 1.50 x 80) in May 1998, 3 years after intrastromal corneal ring segment surgery for high myopia (-30.00 diopters). Ultrasound biomicroscopy revealed an oversized lens, leading to malpositioning. Moreov er, the patient remained undercorrected (20/40 with -5.25 -0.75 x 120). Ten months later, the phakic IOL was uneventfully exchanged for a shorter one with the correct dioptic power. It was well placed in the posterior chamber . The patient's visual acuity was 20/30 with -2.25 -0.75 x 145, very close to the refraction in the fellow aphakic eye (20/30 with -2.50 -0.75 x 75). Patient satisfaction with the final visual outcome was high. Accurate cilia ry sulcus measurement is critical for proper phakic IOL sizing. J Cataract Refract Surg 2000; 26:773-776 (C) 2000 ASCRS and ESCRS.