Long-term study of iris-supported phakic lenses for the treatment of high myopia

Session Details

Session Title: Refractive
Session Date/Time: Sunday 28/02/2016 | 08:30-11:00
Paper Time: 09:12
Venue: Skalkotas
First Author: : T.Kohnen GERMANY
Co Author(s): :    M. Scheffel   M. Koss   M. Shajari        

Abstract Details

Purpose:

To examine the long-term performance of the iris-fixated phakic intraocular lens (Artisan) for correction of high myopia.

Setting:

Department of Ophthalmology, Goethe-University, Frankfurt, Germany

Methods:

Two models of the Artisan (optical zone 5mm n=16, optical zone 6mm n=79) were implanted in 95 eyes of 52 highly myopic patients. Follow-up exams at 1, 12, 24, 36, and 48 months included corrected distance visual acuity (CDVA - 5m Snellen charts), central corneal endothelial cell density (CED) and evaluation of adverse events (AE). Three cohorts dependent on ACD were established (ACD <3.00mm; 3.00-3.39mm; >3.40mm) and compared in terms of CED. Statistical analysis included a linear regression analysis for the evaluation of influence of anterior chamber depth (ACD) on CED.

Results:

4 years after surgery the mean spherical equivalent changed from -11.06 ±4.77D (median -10.5D, range -5.38 to -31.50D) to -0.42 ±0.47D (range -1.75 to +0.88D). No patient lost two or more lines at any time. CED was 2497 ±329cells/mm2 (1605 to 3164cells/mm2) equaling a loss of 11% compared to the preoperative status. Severe AE were not detected. There was a significantly higher loss in CED in patients with an ACD less than 3.00mm compared to those with more than 3.40mm (P=0.00). There was no significant difference in terms of CED in eyes with ACD 3.00-3.39mm to eyes with ACD >3.40mm.

Conclusions:

The iris-fixated pIOL is a precise and predictable method for the correction of high myopia if extensive preliminary examination is performed and strict inclusion criteria are followed. However, the loss of corneal endothelium can be significant. Establishing stricter exclusion criteria for ACD is an option to reduce the risk for severe loss in CED.

Financial Disclosure:

NONE