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AcrySof Cachet phakic intraocular lens for moderate to high myopia: two year results

Session Details

Session Title: Phakic IOL Implantation I

Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00

Paper Time: 14:36

Venue: Main Lecture Hall (Ground Floor)

First Author: : M.Doors THE NETHERLANDS

Co Author(s): :    A. Aerts   T. Berendschot   R. Nuijts        

Abstract Details

Purpose:

To evaluate the efficacy, safety and stability of the angle-supported Acrysof Cachet phakic intraocular lens (pIOL) to correct moderate to high myopia, and compare endothelial cell (EC) loss to EC loss after iris-fixated Artisan and Artiflex pIOL implantation.

Setting:

University Eye Clinic, Maastricht University Medical Center, The Netherlands

Methods:

In this prospective study, 117 eyes were included who underwent Acrysof Cachet pIOL implantation for moderate tot high myopia ranging from -6.00 to -16.5 diopters (D). Preoperatively and 6 month, 1 and 2 years postoperatively, uncorrected and best-corrected visual acuity (UCVA; BCVA), spherical equivalent (SE), EC counts and adverse events were documented. Furthermore, we compared EC loss to EC loss after Artisan (n=369 eyes), Artiflex (n=237 eyes) and toric Artisan (n=102 eyes) implantation at 6 months, 1 year and 2 years postoperatively. All surgical procedures were performed by the same surgeon.

Results:

UCVA was 20/40 or better in 84 (100%) and 30 (100%) of eyes and 20/20 or better in 55 (65.5%) and 16 (53.3%) of eyes at 1 (n=86) and 2 (n=30) years postoperatively, respectively. BCVA was 20/32 or better in 86 (100%) and 30 (100%) of eyes and 20/20 or better in 80 (93%) and 28 (93.3%) of eyes at 1 (n=86) and 2 (n=30) years postoperatively, respectively. Mean postoperative SE was -0.29 ± 0.40D at 2 years postoperatively. Residual refractive error was within ±0.50D of intended refraction in 84% and 75%, and within ±1.00D in 98% and 94% at 1 and 2 years postoperatively, respectively. No eyes lost 2 or more lines of BCVA. Safety-index was 1.08 and 1.05 at 1 and 2 years after implantation, respectively. One patient developed pupil ovalization, which resulted in explantation of the pIOL. EC loss was 3.74 %, 5.07% and 7.36% at 6 months, 1 and 2 years postoperatively, respectively. Compared to the EC losses with the Artisan and Artiflex pIOL, the Cachet pIOL showed a significantly larger loss (P<0.05). However, when excluding the surgical loss, there were no significant differences between these 3 pIOL types in EC loss (P>0.05).

Conclusions:

The Acrysof Cachet pIOL effectively corrects moderate to high myopia, with good predictability and stability. Concerning the safety, no eyes loss 2 or more lines of BCVA. However, acute surgical EC loss is larger with the Cachet pIOL when compared to the Artisan and Artiflex iris-fixated pIOL.

Financial Interest:

NONE