# Prototype posterior chamber phakic IOL – 35 year follow up

## TL;DR

A rare prototype intraocular lens implanted 35 years ago was successfully removed from a patient with cataract and high myopia, resulting in improved vision.

## Contribution

This case highlights the long-term clinical outcomes and successful removal of a rarely seen prototype posterior chamber phakic IOL.

## Key findings

- The PC-pIOL was easily extracted without complications.
- The patient achieved 20/25 best corrected visual acuity one month after surgery.
- Aphakia after vitrectomy was a viable option in this case.

## Abstract

To present a case involving a rarely seen prototype posterior chamber phakic IOL (PC-pIOL) in a highly myopic patient with bilateral cataract.

A 64-year-old male presented to our clinic with poor vision in both eyes. Clinical examination revealed bilateral mature cataract, phacodonesis as well as a PC-pIOL implanted 35 years ago to address his high myopia. The visual acuity (VA) was 20/200 in the right eye and no light perception in the left eye. PC-pIOL extraction as well as 23G pars plana vitrectomy (PPV) and fragmentation surgery was scheduled for the right eye. The left eye was treated conservatively. Successful extraction of the PC-pIOL was performed while it was easy to remove. It was a bow-tie shaped lens with a collar-stud-like button in the middle which extended anteriorly into the anterior chamber through the pupil. PPV with lens fragmentation was successful and the patient was left aphakic in order to avoid the placement of a zero diopter IOL. Final best corrected VA was 20/25 one month post-surgery.

Removal of this rarely seen pIOL was performed without difficulty while excellent VA was achieved. Aphakia following complete vitrectomy represented a viable option in this case. Furthermore, we highlight the clinical manifestations associated with this IOL more than three decades after implantation.