BILATERAL CATARACT AFTER PHAKIC POSTERIOR CHAMBER TOP HAT-STYLE SILICONE INTRAOCULAR-LENS

BACKGROUND: New strategies have been developed for surgical treatment of high myopia. Recently, implantation of minus power posterior chambe r intraocular lenses (IOL) into phakic eyes has been introduced. METHO DS: We report a 31 year-old female patient who developed bilateral ant erior subcapsular cataract 7 years after minus-power, top hat-style si licone posterior chamber IOL implantation in Russia. The corrected vis ual acuity was right eye 20/200 and left eye 20/63. Because of the hig h myopia and the posterior chamber IOL in her phakic eyes, biometry fo r IOL calculation gave contradictory results. Both posterior chamber I OLs were found to be adherent to the crystalline lenses. after posteri or chamber IOL explantation and phacoemulsification, intraoperative re tinoscopy was performed. With this aphakic refraction, the IOL power w as calculated and implanted. The explanted posterior chamber IOLs were examined by scanning electron microscopy. RESULTS: After bilateral op eration the corrected visual acuity increased to right eye 20/32 and l eft eye 20/40, respectively. On scanning electron microscopy, a membra nous structure of unknown origin was noted on the entire surface of th e explanted posterior chamber IOLS. CONCLUSION: There is a potential r isk of cataract formation after implantation of this top hat-style sil icone posterior chamber IOL. If cataract extraction in this specific s ituation is needed, a different approach for calculating the aphakic I OL power is necessary, such as intraoperative retinoscopy.