Clinical observation of posterior chamber intraocular lens implantation combined with corneal laser surgery for correction of super high myopia

Abstract

Objective To observe the efficacy, safety and predictability of implantable collamer lens (ICL) implantation combined with corneal laser surgery to correct super high myopia. Methods Prospective study. A total of 7 patients (13 eyes) with SE (equivalent spherical refraction)≥-16.0D were selected. First, ICL surgery was done to correct most of the refractive errors, 3 months later, secondary corneal laser surgery to correct the remaining refractive error. Results The best corrected visual acuity (BCVA) was (4.63±0.29) before the surgery. Postoperative uncorrected visual acuity (UCVA) was (4.75±0.19), UCVA of 11 eyes achieved level of preoperative BCVA (84.62%, 11/13). Compared with BCVA before combined surgery, a gain of 1 line of UCVA was seen in 3 eyes, a gain of 3 lines and above of UCVA was seen in 4 eyes (53.85%, 7/13). Efficacy ratio and safety ratio of the operative was 102.81% and 103.24%, respectively. One month after combined surgery, the UCVA over 4.7 was 8 eyes, accounting for 61.54%. The residual refraction within ±1.0D of emmetropia was 9 eyes and within ±0.5D was 5 eyes (81.82%, 9/11). The intraocular pressure, anterior chamber depth and anterior chamber volume were significantly lower than that before operation (P 0.05). The number of corneal endothelial cells after combined surgery was lower than that before combined surgery. The corneal endothelial cell density was >2000/mm2 at last examination. Complications related to infection, lens dislocation, glaucoma, cataract was not observed. But 1 eye of 1 person suffered rhegmatogenous retinal detachment, 2 eyes of 1 person with night glare and halo, 1 person had dry eye symptoms. Conclusions Implantable collamer lens (ICL) implantation combined with corneal laser surgery is a safe, effective and predictable method to correct super high myopia in short-term after combined surgeries. Key words: Phakic eyes; Corneal refractive surgery; Combined surgery; Super high myopia