Phakic posterior chamber intraocular lens for high myopia☆

Purpose: To evaluate the efficacy, predictability, stability, and safety of the surgical correction of high myopia using a phakic posterior chamber intraocular lens (PPC IOL).

Setting: Centro Oftalmológico de Valencia-CEOVAL, Valencia, Venezuela.

Methods: A retrospective study was performed to analyze 18 eyes of 12 patients who had implantation of a modified PPC IOL, the implantable contact lens (ICL), for the treatment of high myopia. The target postoperative spherical equivalent (SE) refraction was emmetropia.

Results: The mean follow-up was 26.6 months ± 11.3 (SD) (range 12 to 36 months). The mean preoperative SE was −15.27 ± 3.47 diopters (D) (range −10.0 to −21.25 D) and the mean postoperative SE, −0.62 ± 0.81 D (range −2.75 to +0.75 D). Eleven eyes (61.1%) had an SE within ±1.00 D of emmetropia. The best spectacle-corrected visual acuity was maintained or improved in all except 1 eye, which lost more than 2 lines of Snellen visual acuity. Two eyes (11.1%) developed pupillary block the first day after surgery. Four eyes (22.2%) had moderate pigmentary dispersion. Two eyes (11.1%) had lens opacification, 1 with mild peripheral anterior capsule opacification and the other eye with central anterior subcapsular opacification. One eye (5.5%) had a significant decrease in anterior chamber depth after surgery.

Conclusions: Implantation of an ICL was effective for the correction of high myopia. Predictability must be improved and the long-term safety of the ICL determined. The main concerns over potential cataract formation, pigmentary dispersion, and angle-closure glaucoma remain.