Phakic Intraocular Lens For Correction Research Articles

Posterior chamber phakic intraocular lens for correction of high myopia

Objective To observe the clinical efficacy of posterior chamber phakic intraocular lens (ICL)for correction of high myopia. Methods The data of 110 eyes of 55 cases with high myopia(-6.00 D--18.00 D)who received ICL implantation from Dec. 2017 to Sep. 2018 were collected and analyzed retrospectively. The patients were followed up for 3 months. The data were observed and analyzed between preoperative and postoperative. Results The differences of the average uncorrected visual acuity, best corrected visual acuity(LogMAR) and refraction were statistically significant between preoperative and 3 months postoperatively(t=14.580, 13.240, 11.770, P=0.010, 0.021, 0.013). There was significant difference of the root mean square value in the general lower-order aberrations between preoperative and 3 months postoperatively(t=-18.780, P=0.000). The differences in the general higher-order aberrations, 3-order aberrations, 4-order aberrations, and 5-order aberrations root mean square value were not statistically significant between preoperative and 3 months postoperatively(t=-1.278, 0.785, 0.351, 0.457, P=0.125, 0.412, 0.224, 0.324). The differrences of Z40, Z31, Z3-1, Z33, Z3-3 were not statistically significant between preoperative and 3 months postoperatively (t=0.654, 0.545, 0.387, 0.268, 0.578, P=0.547, 0.371, 0.241, 0.187, 0.428). Conclusion Posterior chamber phakic intraocular lens is safe, effective, predictable and stable for correction of high myopia and postoperative visual quality is good. Key words: Lens, intraocular, phakic, posterior chamber; Myopia, high; Visual quality

История развития ФИОЛ в лечении миопии высокой степени

The article provides a review of the literature on the history and practical application of phakic intraocular lenses for correction of high myopia. Typical postoperative complications for each design of the lens are described as well as peculiarities of the effect on the eye tissues depending on the location. The analysis of a safety and prognostic expectations in refractive effect is carried out. The available results in the literature allow to evaluate a high efficiency of phakic intraocular lens implantation in the correction of ametropies of various degrees, that is why this method of implantation has been attracting the attention of ophthalmic surgeons for a long time.

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

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.

Comparison of three phakic intraocular lenses for correction of myopia.

Purpose:To compare the visual outcomes and complications of three different types of phakic intraocular lenses (PIOLs), for correction of moderate to high myopia.Methods:We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer lens (ICL, 36 eyes). Best corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared.Results:Mean follow-up period was 30 ± 11 months. Preoperatively, spherical equivalent (SE) refractive error was −11.6 ± 3.7, −9.59 ± 1.97, and −12.3 ± 4.8 D in the Artisan, Artiflex and ICL groups, respectively. SE was comparable among the study groups at final follow-up (P = 0.237). Mean astigmatic reduction was 0.31 ± 0.72, 0.45 ± 0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P = 0.007). Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P = 0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P = 0.158); pachymetric changes were minimal with no difference among the three groups (P = 0.754), and mean CEC loss was 10 ± 9%, 9 ± 6% and 9 ± 10% in the Artisan, Artiflex and ICL groups, respectively (P = 0.694). HOAs (P = 0.039), vertical trefoil (P = 0.032) and spherical aberration (P = 0.001) were higher with Artisan group as compared to ICL. Total aberrations (P = 0.028) and spherical aberration (P = 0.001) was also higher with Artisan group as compared to Artiflex.Conclusion:Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.

Angle-supported phakic intraocular lens for correction of moderate to high myopia: Three-year interim results in international multicenter studies

Angle-supported phakic intraocular lens for correction of moderate to high myopia: Three-year interim results in international multicenter studies

Angle-supported phakic intraocular lens for correction of moderate to high myopia: Three-year interim results in international multicenter studies

To evaluate the safety and effectiveness of an angle-supported phakic intraocular lens (pIOL) for correction of moderate to high myopia. Ophthalmology centers in the United States, Canada, and the European Union. Cohort study. This study comprised patients with moderate to high myopia (range -6.00 to -16.50 diopters [D]) who had implantation of the AcrySof Cachet pIOL. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), predictability, stability of the manifest refraction spherical equivalent (MRSE), adverse events, and endothelial cell density (ECD). Pooled interim data from 360 patients assessed for up to 3 years postoperatively are presented. Of the 104 patients who reached the 3-year visit, the UDVA was 20/40 or better in 101 (97.1%) and 20/20 or better in 48 (46.2%). The CDVA was 20/32 or better in 103 (99.0%) of the 104 patients and 20/20 or better in 84 patients (80.8%). The mean MRSE was -0.24 D ± 0.55 (SD) (range -2.00 to 1.63 D). The residual refractive error was within ±0.50 D of target in 82 patients (78.8%) and within ±1.00 D in 95 patients (91.3%). The annualized percentage loss in central ECD and peripheral ECD from 6 months to 3 years was 0.41% and 1.11%, respectively. No pupil ovalization, pupillary block, or retinal detachment was observed. Three-year findings from pooled global studies showed that the angle-supported pIOL provided favorable refractive correction and predictability and acceptable safety in patients with moderate to high myopia.

5-Year Prospective Follow-Up of Artisan Phakic Intraocular Lenses for the Correction of Myopia, Hyperopia and Astigmatism

Aim: To determine the efficacy and safety of Artisan phakic intraocular lenses (IOLs) for refractive error correction. Methods: A prospective study was conducted on patients undergoing Artisan phakic IOL implantation for myopia, hyperopia or astigmatism from 2002 to 2008. Visual acuity, manifest refractive spherical equivalent (MRSE), endothelial cell counts and higher order aberrations were recorded pre- and postoperatively. Results: One hundred and fifty-one (84 patients) myopic (mean MRSE –11.2 ± 4.1 D) and 14 (7 patients) hyperopic eyes (mean MRSE 7.1 ± 1.3 D) were treated. Twenty eyes (11 patients) had toric IOLs to correct astigmatism (mean MRSE –9.05 ± 6.13 D, mean astigmatism 4.06 ± 1.26 D). Three months postoperatively, mean MRSE in 37.6% of eyes was within ±0.5 D, 61.8% within ±1.0 D and 91.4% within ±2.0 D. 18.5% underwent keratorefractive surgery to correct residual refractive error. A 1.56-fold increase occurred in 4th order spherical aberration. Endothelial cell loss was 1.45% at 1 year and negligible at 5 years. Fifty-four eyes (29.2%) gained one or more lines of best corrected visual acuity and no eye lost a line. Conclusion: Artisan phakic IOLs are safe and effective for refractive error correction.

Posterior chamber phakic intraocular lens for correction of extreme myopia

To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of extreme myopia. This study included 216 eyes of 113 patients with a mean age of 30 years (18 approximately 49) from January 1997 to December 2005. An implantable contact lens (ICL V2 and V4, Staar Surgical Inc.) was inserted. Patients were examined preoperatively and followed at 1 day, 1 week, 1, 3, 6, 12, 24, and 36 months postoperatively. The examination content included the uncorrected visual acuity, best corrected visual acuity (BCVA), slitlamp examination, refraction, intraocular pressure, endothelial cell morphometry, etc. Spherical equivalent was (17.78 +/- 3.88) diopters before the operation. Surgical implantation was performed through a 3.2 mm clear corneal sutureless incision using paraocular anesthesia. The mean follow-up period was 18.2 months (ranged 6 to 24 months) for refractive data and 24.3 months (ranged 6 to 36 months) for the complications. Successful implantation was achieved in all patients. Postoperatively, all eyes had a significant increase in uncorrected visual acuity. The mean spherical equivalent refraction at the last examination was (-1.00 +/- 1.40), within +/- 1.00 D of the targeted refraction in 191 eyes (88.4%) and within +/- 0.50 D in 165 eyes (76.4%). In eyes in which the preoperative myopia was less than 20.00 D (n = 151), the achieved refraction was within +/- 1.00 D of the intended refraction in 145 eyes (96.0%) and within +/- 0.50 D in 128 eyes (84.8%). The refraction remained stable with a statistically insignificant change (P > 0.05) at each interval during the follow-up. The best corrected visual acuity (BCVA) improved by 1 or more lines in 168 eyes (77.8%) at 1 year after the operation. Four eyes (1.85%) lost 1 line of BCVA. Pupillary block glaucoma requiring surgical intervention occurred in 4 eyes (1.85%). Three eyes (1.39%) developed cataract 1 year after ICL (V2) implantation, all ICLs in these eyes were removed, and the refractive errors were corrected by lensectomy and implantation of low-power posterior chamber IOLs. BCVA was mentioned in all of these eyes. Posterior chamber phakic intraocular lens implantation appears to be an effective, safe and reliable method for the correction of extreme myopia.

Secondary Artisan Phakic Intraocular Lens for Correction of Progressive High Myopia in a Pseudophakic Child

An 8-week-old infant underwent unilateral cataract extraction and posterior chamber intraocular lens implantation for total cataract in the left eye. After surgery, a residual progressive myopic error was observed, ranging from -4.5 diopters (D) 6 months after the operation to -14.0 D at the age of 3 years. Because of parental noncompliance for contact lens and spectacles use, secondary implantation of Artisan phakic IOL of -14.0 D power was performed. No intra- or postoperative complications were observed. Nine months after this second operation, myopia diminished to -3.25 D.

Artisan Toric Phakic Intraocular Lens for Correction of Astigmatism

To assess the safety and efficacy of implanting Artisan toric phakic intraocular lenses (PIOLs) (Ophtec BV, Groningen, The Netherlands) in eyes with high degrees of compound myopic, hyperopic, and mixed astigmatism. Twenty-five eyes (20 patients) presenting with high astigmatism were implanted with Artisan toric PIOLs and followed for 1 year. Group 1 included 8 eyes (myopic astigmatism), group 2 included 9 eyes (hyperopic astigmatism), and group 3 included 8 eyes (mixed astigmatism). In the myopic astigmatism group, 8 (100%) of 8 eyes had preoperative uncorrected visual acuity (UCVA) of < or = 20/50, and at 6-month follow-up, 5 (62.5%) of 8 eyes had UCVA of > or = 20/40 (P = .005). In this group, 75% of eyes were within +/- 1.00 diopter (D) of the intended correction. In the hyperopic astigmatism group, 8 (88.9%) of 9 eyes had preoperative UCVA of < or = 20/40, and at 6-month follow-up, 6 (66.6%) of 9 eyes had UCVA of > or = 20/32 (P = .199). Approximately 77.8% of eyes were within +/- 1.00 D of the intended correction. In the mixed astigmatism group, 8 (100%) of 8 eyes had preoperative UCVA of < or = 20/50, and at 6-month follow-up, 6 (87.5%) of 8 eyes had UCVA of > or = 20/40 (P = .007). In this group, 87.5% of eyes were within +/- 1.00 D of the intended correction. The safety index of the procedure was 1.6, 1.3, and 1.3 in the myopic, hyperopic, and mixed astigmatism groups, respectively. The efficacy index of the procedure was 1.2, 1.0, and 1.0 in the myopic, hyperopic, and mixed astigmatism groups, respectively. Artisan toric PIOLs are safe for the correction of high degrees of astigmatism associated with myopic or hyperopic spherical refractive defect.