Implantation of phakic anterior chamber intraocular lens for the correction of severe myopia

Abstract

To evaluate the efficacy, safety, and predictability of the implantation of phakic anterior chamber intraocular lens (PAC-IOL) for the correction of severe myopia. In this prospective study, 15 cases (29 eyes) with myopia at -15.00 - -24.50 dioperts (D) were implanted with Phakic 6H(2) PAC-IOL. Visual acuity, refraction, intraocular pressure, corneal endothelium, the PAC-IOL position, contrast sensitivity, glare sensitivity, operative complications and poor visual symptoms were observed. Postoperative uncorrected visual acuity 0.5 or better was presented in 79.3% eyes (23/29) at 3 months and in 82.6% eyes (24/29) at 6 months. Best corrected visual acuity 0.8 or better was presented in 69.0 % eyes (20/29) at 3 months and in 69.0% eyes (20/29) at 6 months, they were all significantly better than that of preoperative values (P < 0.05); and there was no statistically significant difference between visual acuity at 3 months and 6 months (P > 0.05). Compared with preoperative best corrected visual acuity, postoperative uncorrected visual acuity improved 2 lines or more in 70.0% of eyes (20/29) at 3 months and 72.4% eyes (21/29) at 6 months. The mean postoperative spherical equivalent refraction was -1.00D at 3 months, -1.00D at 6 months, they were significantly lower than that of preoperative values (P < 0.05); and there was no statistically significant difference of spherical equivalent refraction between 3 months and 6 months (P > 0.05). There were no statistically significant difference between pre- and post-operative mean intraocular pressure, corneal endothelial density (P > 0.05) at 3 and 6 months. There was no significant difference of these data between 3 months and 6 months (P > 0.05). The PAC-IOL was located (2.341 +/- 0.116) behind the central cornea, (0.841 +/- 0.140) mm in front of the crystalline lens. The footplates appeared to be correctly positioned in the anterior chamber angle in all eyes. Contrast sensitivity and glare sensitivity in all spatial frequencies increased at 6 months post-operatively as compared with those of preoperative values (best spectacle-corrected) (P < 0.05). Postoperative complications included a slight inflammatory deposits on the PAC-IOL surface at 3 months in 10.3% eyes (3/29) and 6.9% eyes (2/29) at 6 months; oval pupil in 10.3% eyes (3/29); PAC-IOL rotation in 27.6% eyes (8/29); night glare in 17.2% eyes (5/29); all of the other patients were satisfied. PAC-IOL implantation for the correction of severe myopia is effective, safe and predictable. It can be a supplement for corneal refractive surgery, but follow-up is still required for the evaluation of long-term results.