Twelve year follow-up of unfenestrated polysulfone intracorneal lenses in human sighted eyes

Purpose: To evaluate unfenestrated polysulfone intracorneal lenses (ICLs) in human sighted eyes 12 years after their implantation and to assess eyes that had the ICLs explanted. Setting: A department of clinical ophthalmology at a general hospital and the Department of Pathology at the National Institute of Ophthalmology, London, Great Britain. Methods: In this retrospective study, seven eyes were evaluated 12 to 14 years after ICL implantation. Case notes were scrutinized for preoperative ophthalmic history, and patients were interviewed and examined to establish outcome of the ICL implantation. Histopathological correlates were made for two study patients who had had ICL explantation and penetrating keratoplasty (PKP). Results: Uncorrected visual acuity in eyes retaining the ICL ranged between hand motion and 20/40, improving to 20/32 with correction. Corneal clarity varied between complete lucency to extensive opacity on each ICL surface. No corneal vascularization, endothelial decompensation, or uveitis was seen in eyes with clear ICLs. Acuity in eyes in which the ICL was explanted was between 20/20 corrected and finger counting in cases of PKP and between 20/200 and hand motion in eyes after lamellar keratoplasty. Conclusion: Despite satisfactory surgical technique in some eyes, unfenestrated polysulfone appears to be associated with color change and varying degree of stromal opacity in eyes evaluated 12 years postoperatively and thus cannot be considered clinically acceptable.