Posterior chamber phakic intraocular lens (ICL) for hyperopia: ten-year follow-up

Paolo M Pesando, Maria Pia Ghiringhello, Giuseppe Di Meglio, Giordano Fanton
Journal of Cataract and Refractive Surgery 2007, 33 (9): 1579-84

PURPOSE: To evaluate the long-term safety, efficacy, predictability, and stability of implantation of a Collamer implantable contact lens (ICL) (Staar) to correct hyperopic refractive errors.

SETTINGS: Ophthalmology Department, Santa Rita Hospital, Vercelli, Italy.

METHODS: Fifty-nine eyes of 34 patients with hyperopia had implantation of an ICL. Patients were examined preoperatively (baseline) and 1 day, 1 week, 1, 3, and 6 months, and 1, 2, 4, 6, 8, and 10 years postoperatively. Main outcome measures were subjective and objective refractions, uncorrected visual acuity, best corrected visual acuity (BCVA), variation in intraocular pressure (IOP), anterior chamber depth (ACD), variation in endothelial cells, adverse events, and patient satisfaction.

RESULTS: Nine patients had ICL implantation in 1 eye and 25 patients, in both eyes. Preoperatively, the spherical equivalent (SE) was between +2.75 diopters (D) and +11.75 D and astigmatism was between +0.50 D and +1.00 D. The mean SE of the manifest refraction was +0.07 +/- 0.54 D; refraction stabilized quickly and remained stable throughout the follow-up period. At 10 years, the safety index was 111 and the efficacy index, 96.8. Of the eyes, 86.5% had a change in SE refraction within +/-0.50 D; 1.6% lost 1 Snellen line of BCVA. The mean endothelial cell loss was 4.7%, which remained almost unchanged throughout the follow-up period. The mean variation in ACD was -14.9% and in IOP, +5.3%.

CONCLUSIONS: The results confirmed the long-term safety, efficacy, accuracy, and predictability of ICL implantation for hyperopia. The Collamer material was well tolerated in all eyes.

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