Bilensectomy: Safety and Visual Outcomes in Angle-Supported, Iris-Fixated, and Posterior Chamber Phakic Intraocular Lenses.

Objective: To report the visual and refractive outcomes, intraoperative and postoperative complications, and main causes of bilensectomy in the different types of phakic intraocular lenses (pIOLs).

Methods: This was a retrospective multicenter study that included 234 eyes of 185 patients that underwent bilensectomy. Patients were divided into three groups depending on the pIOL that was explanted (angle-supported, iris-fixated, or posterior chamber). The main reasons leading to the indication for bilensectomy, time elapsed between pIOL implantation and bilensectomy, intraoperative and postoperative complications, uncorrected and corrected distance visual acuity (UDVA and CDVA), and endothelial cell density loss 1 year after bilensectomy were evaluated.

Results: There was a statistically significant improvement in UDVA and CDVA after bilensectomy in all groups. Cataract development was the main reason for bilensectomy, followed by significant endothelial cell density loss. Time between pIOL implantation and bilensectomy was significantly greater in eyes with an anterior chamber pIOL.

Conclusions: Bilensectomy outcomes in general are good. Iris-fixated lenses, particularly hyperopic, are more prone to intraoperative complications and endothelial cell loss than the other pIOLs models. The results show that bilensectomy is a safe and effective procedure with a relatively low rate of intraoperative and postoperative complications and acceptable refractive predictability. [J Refract Surg. 2023;39(3):128-134.].