An angle-supported foldable phakic intraocular lens for correction of myopia: A five-year follow-up

Abstract

Abstract Objective To evaluate the efficacy and safety of an angle-supported foldable phakic intraocular lens (pIOL) for the correction of moderate to high myopia after 5 years follow-up. Methods Prospective and retrospective, observational, longitudinal, non-randomised consecutive series of cases conducted on a total of 100 eyes of 67 patients with moderate to high myopia implanted with an Acrysof Cachet pIOL (Alcon Laboratories Inc.) with the aim of minimizing the refractive error. The ages ranged between 18 and 60 years. Uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity (CDVA), endothelial cells density, pIOL position, intraocular pressure, and complications were recorded preoperatively and during the 5 year follow-up. Results Five years after implantation, the mean manifest spherical equivalent refraction reduced significantly from −11.62 ± 3.35 dioptres (D) to −0.33 ± 0.85 D. UDVA was 20/20 or better in 5 of 25 cases (20%), and 20/40 or better in 22 cases (88%). CDVA was 20/20 or better in 17 cases (68%), and 20/32 or better in 23 cases (92%) of eyes. The residual refractive error was within ±0.50 D of emmetropia in 12 cases (48%), and within ±1.00 D in 19 cases (76%). Mean endothelial cell loss at 5 years was 11.8% central, and 13.7% peripheral. Mean endothelium-pIOL distance was 2.11 ± 0.18 mm, and mean pIOL-crystalline distance was 0.88 ± 0.20 mm. Conclusions This angle supported pIOL provided a favorable refractive correction and predictability, as well as acceptable safety in patients with moderate to high myopia. Although endothelial cell density decreased over 5 years, the results are within the range reported in previous studies with other pIOLs.