26doc121 10.3205/26doc121 urn:nbn:de:0183-26doc1212 Meeting Abstract Hokama Hokama Lisa L

Keio University, School of Medicine, Tokyo, Japan

author Yokomizo Yokomizo Mayumi M

Keio University, School of Medicine, Tokyo, Japan

author Negishi Negishi Kazuni K

Keio University, School of Medicine, Tokyo, Japan

author German Medical Science GMS Publishing House

Düsseldorf

610 20260617 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0651 121 38. Internationaler Kongress der Deutschen Ophthalmochirurgie (DOC) Hornhaut Nürnberg 20260618 20260620 EPO 3.1 TextPurpose: To report two cases of bullous keratopathy following implantation of an iris-claw anterior chamber phakic intraocular lens (p-IOL), both of which required p-IOL explantation and subsequent endothelial keratoplasty. Method: We reviewed two patients who developed corneal endothelial decompensation after implantation of Artiflex: iris-claw anterior chamber p-IOL. Clinical findings, endothelial cell density (ECD), surgical interventions, and postoperative outcomes were evaluated. Result: Case 1: A 57-year-old female underwent bilateral Artiflex implantation at age 39. Six years postoperatively, a marked decrease of ECD in the left eye was noted (from 2,207 to 523 cells/mm2), and peripheral bullous keratopathy was observed. She underwent p-IOL explantation combined with phacoemulsification and intraocular lens implantation. Postoperatively, the bullous keratopathy worsened, and non-Descemet’s membrane stripping automated endothelial keratoplasty (nDSAEK) was performed, resulting in good visual recovery. Case 2: A 48-year-old male had undergone bilateral Artiflex implantation at age 38 without subsequent follow up. He presented at age 47 with left ocular pain. Peripheral bullous keratopathy was noted, with a central ECD of 630 cells/mm2 and ECD of 420 cells/mm2 at the iris claw fixation site. He underwent p-IOL explantation combined with phacoemulsification and intraocular lens implantation, but postoperative worsening of bullous keratopathy necessitated nDSAEK. Postoperative visual outcomes were favorable. Conclusions: Eyes implanted with iris claw anterior chamber p-IOLs require careful long-term monitoring due to the risk of progressive corneal endothelial cell loss. Once endothelial decompensation advances, p-IOL explantation and endothelial keratoplasty may become necessary. These cases underscore the importance of strict postoperative surveillance in patients with this type of p-IOL. 0 0 0 0