Phakic intraocular lens: Two-year results and comparison of endothelial cell loss with iris-fixated intraocular lenses

• Published in: Journal of cataract and refractive surgery Vol. 41; no. 10; pp. 2258 - 2265
• Main Authors: Aerts, Andreas A.S., MD, Jonker, Soraya M.R., MD, Wielders, Laura H.P., MD, Berendschot, Tos T.J.M., PhD, Doors, Muriël, MD, PhD, De Brabander, John, PhD, Nuijts, Rudy M.M.A., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015
• Subjects: Adult; Corneal Endothelial Cell Loss - diagnosis; Corneal Endothelial Cell Loss - etiology; Female; Follow-Up Studies; Humans; Iris - surgery; Lens Implantation, Intraocular; Male; Middle Aged; Myopia, Degenerative - physiopathology; Myopia, Degenerative - surgery; Ophthalmology; Phakic Intraocular Lenses; Postoperative Complications; Retrospective Studies; Treatment Outcome; Visual Acuity - physiology
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2015.10.039

Purpose To evaluate the efficacy, safety, and stability of a foldable angle-supported Acrysof Cachet phakic intraocular lens (pIOL) to correct moderate to high myopia and compare endothelial cell loss after iris-fixated Artisan and Artiflex pIOL implantation. Setting University Eye Clinic Maastricht, the Netherlands. Design Retrospective observational study. Methods Foldable angle-supported pIOL implantation for myopia ranging from −6.0 to −16.5 diopters (D) was done. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, spherical equivalent (SE), and adverse events were documented preoperatively and 6 months and 1 and 2 years postoperatively. Endothelial cell loss after implantation of the foldable angle-supported pIOL and iris-fixated pIOLs was compared 6 months and 1 and 2 years postoperatively. Results There were 158 eyes. The UDVA was equal to or more than 20/25 in 95% of eyes at 1 and 2 years postoperatively. The mean SE was −0.17 D ± 0.43 (SD) 2 years postoperatively. One patient developed pupil ovalization, resulting in explantation of the pIOL from both eyes. Acute endothelial cell loss in the foldable angle-supported pIOL group was −3.2% ± 0.7%, significantly higher than after iris-fixated pIOL implantation. Chronic endothelial cell loss from 6 to 24 months after surgery was −3.8% ± 0.7%. At the 2-year follow-up, the chronic endothelial cell loss in the foldable angle-supported pIOL group was not different than with iris-fixated pIOLs ( P > .05). Conclusions The foldable angle-supported pIOL effectively corrected moderate to high myopia. However, acute surgical endothelial cell loss was significantly higher than with iris-fixated pIOLs. Financial Disclosure Dr. Nuijts is a consultant to Alcon Laboratories, Inc., Théa Pharma GmbH, and ASICO LLC; he has received study grants from Acufocus, Inc., Alcon Laboratories, Inc., Carl Zeiss Meditec AG, Ophtec BV, and Physiol S.A. No other author has a financial or proprietary interest in any material or method mentioned.