Official ESCRS | European Society of Cataract & Refractive Surgeons

 

The challenge of presbyopic phakic implantation

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Session Details

Session Title: Presented Poster Session: After Surgery

Venue: Poster Village: Pod 1

First Author: : J.Corre FRANCE

Co Author(s): :    B. Cochener-Lamard                       

Abstract Details

Purpose:

Avoiding the extraction of a clear eye lens thanks to a phakic IOL capable of safely compensating for accommodation loss is a promising concept. A new IOL has just been released, which was boldly proposed to an high hyperopic patient.

Setting:

University Hospital Brest Morvan - 2018. Pr Cochener.

Methods:

Mr. Y, 44 years old, presented for refractive surgery with high hyperopia (OD +9.00 and OG +9.25 D) combined with regular astigmatism (OD -1.75 and OG -1.00 D), for a best corrected visual acuity of 20/20 OD and 20/25 OG. Although he had a history of ocular reeducation in childhood, he had normal oculomotricity and preserved binocular vision. The addition required for J1 was + 1.00 D. Surprisingly, eye imaging revealed an anterior chamber depth of 2.9 mm in both eyes, while OSI confirmed crystalline transparency (0.4 and 0.7). An IPCL (Care Group) posterior chamber implant was selected.

Results:

The IOL’s manufacturing was customized. It is a foldable implant, which toricity is intern and is positioned horizontally. The lens was aligned using an automated intraoperative platform Calisto (Zeiss). No intra or postoperative complication are reported, with normal intraocular pressure and a uncorrected visual recovery after suture removal at D4 of : 20/ 20 OD and 20/25 OS and 20/20 J1 in binocular vision. In itrace, the Total HOA is 0.204 OD and 0.199 OG.

Conclusions:

High hyperopia often requires clear lens extraction due to a lack of space to perform a phakic implantation, which leads to the problem of multifocal implantation, source of impaired vision quality. The optical profile of this new pkaic IOL seems to offer good vision quality in addition to the refractive target achieved.  The implantation of phakic IOL (IPCL) provides a new, minimally invasive, effective and reversible solution to address presbyopia correction by maintaining the lens clear and respecting the cornea.

Financial Disclosure:

None

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