A 40-year-old lady presented with serious endothelial cell reduction in both eye 14 years after angle-supported phakic intraocular zoom lens (Seeing that PIOL) implantation. Endothelial cell reduction, endothelial keratoplasty, phakic phakic intraocular zoom lens Phakic intraocular zoom lens (IOL) implantation is certainly a surgical method of correct refractive mistake, which allows the optical modification while maintaining lodging.[1,2] Most significant problem reported with angle-supported phakic intraocular zoom lens (AS PIOL) implantation is early or past due endothelial cell reduction.[3C5] We describe a method of one-step bilensectomy (AS IOL explantation and phacoemulsification) and endothelial keratoplasty as cure modality for AS PIOL-induced endothelial decompensation. Case Survey A 40-year-old female was described cornea providers of Sanjivni Eyesight Treatment, Ambala, India, for dimness of eyesight in the still left eye connected with recurrent discomfort, inflammation, and watering since three months. She acquired undergone position backed phakic intraocular zoom lens (AS PIOL) implantation for high myopia (?11 diopter (D) in the proper vision (RE) and C18 D in the left vision (LE) elsewhere in 1995. Apart from her recent complaints in LE, she was comfortable with vision all these years. Her old records pointed out Crenolanib cell signaling that she experienced uneventful surgery. As per her records, her intraocular pressure (IOP) measurements in the early postoperative period were between 14 and 18 mmHg and there was no record of unusual or delayed uveitis in either vision. The model and design of AS PIOL were not pointed out in the records. She denied frequent rubbing of either of her eyes. The individual did not statement any night glare or haloes. The preoperative endothelial cell count and anterior chamber depth (ACD) were not pointed out in her records. On examination, best corrected visual acuity (BCVA) was counting fingers at 1 m Crenolanib cell signaling in LE and 20/60 (C1.5 D sph/C0.5 D cyl at 50) in RE. Slit lamp examination showed circumciliary congestion, diffuse stromal corneal edema, and bullous keratopathy in LE [Fig. 1]. RE experienced clear cornea with no evidence of guttae changes or dispersed pigments on endothelium [Fig. 2]. AS PIOL was present in both eyes which was stable and well placed. Pupil was slightly oval in the meridian of haptics in both eyes. There was no peripheral iridectomy in either vision. Crystalline lens was obvious in RE and was hazily seen in LE. Fundus examination showed myopic retinal degeneration in RE and it was not visible due to corneal edema in LE. IOP measured by Applanation tonometry was 14 and 16 mmHg in RE and LE, respectively. Gonioscopic examination in RE showed well-positioned haptics of AS PIOL at the iridocorneal angle. [Fig. 3] Due to hazy view, gonioscopy could not be performed in the left vision. Central endothelial cell density (ECD) as measured by a noncontact specular microscope (Topcon) in RE was 655 cells/mm2. Coefficient of variance in cell size was 29. Specular image acquisition Crenolanib cell signaling was not possible in LE due to marked corneal edema. Central ultrasonic pachymetry was 532 m in RE and 810 m in LE. White-to-white diameter as measured by Orbscan was 11.7 mm in both eyes. Anterior segment optical coherence tomography (OCT) (Optovue, IOC) of the RE showed planoconcave AS PIOL placed in front of the crystalline lens [Fig. 4]. The distance measured by anterior segment OCT between the phakic intraocular lens edge and peripheral endothelium was 1.77 mm [Fig. 5]. The ACD in RE (3.73 mm) was calculated by adding the distance between the anterior surface of the cornea to the anterior surface of AS PIOL (2.4 mm), thickness of AS PIOL (0.32 mm) and distance between posterior AS PIOL surface to anterior surface of crystalline lens (1.01 mm), Rabbit Polyclonal to Catenin-gamma all measured by anterior segment OCT. OCT image of the anterior segment was not obvious in LE. Open in a separate window Physique 1 Left vision: angle-supported phakic intraocular lens-induced.