Refractive outcomes and complications following angle supported, iris fixated, and posterior chamber phakic intraocular lenses bilensectomy

Purpose of review The manuscript presents a review of published studies regarding the outcomes, causes, and complications of phakic intraocular lens (pIOLs) bilensectomy. All pIOLs will be explanted at some point, therefore is important to know the visual and refractive outcomes following bilensectomy. Recent findings There are few publications about the outcomes following pIOL bilensectomy; in all of them, cataract remains the main cause of bilensectomy. Other causes are endothelial cell density loss and pupil ovalization. The mean time between pIOL implantation and bilensectomy is longer in eyes implanted with an anterior chamber pIOL than in eyes implanted with a posterior chamber pIOL. There is a significant improvement in uncorrected and corrected distance visual acuity after bilensectomy. Some sight-threatening complications like retinal detachment and low endothelial cell density (ECD) after surgery have been reported. Current publications suggest that endothelial cell density loss is more frequent in eyes that underwent bilensectomy for an anterior chamber pIOL. Summary Good visual and refractive outcomes are achieved after bilensectomy, regular endothelial cell density measurements should be performed in all patients implanted with an anterior chamber pIOL to perform a safe bilensectomy.