Phakic intraocular lens for the correction of hyperopia

Annemari Koivula, Charlotta Zetterström
Journal of Cataract and Refractive Surgery 2009, 35 (2): 248-55

PURPOSE: To evaluate surgical outcomes and adverse events associated with the correction of hyperopia with a phakic intraocular lens (pIOL).

SETTING: St. Erik Eye Hospital, Stockholm, Sweden.

METHODS: This prospective single-center cohort study comprised hyperopic eyes having implantation of the PRL pIOL and a 1-year follow-up. Follow-up included evaluation of the uncorrected (UCVA) and best corrected (BCVA) visual acuity, refraction, intraocular pressure (IOP), endothelial cell counts, and adverse events. The main outcome measures were efficacy, safety, predictability, stability, and changes in endothelial cell density and IOP.

RESULTS: Forty eyes of 25 patients (mean age 32 years; range 21 to 44 years) were evaluated. At 1 year, all eyes were within +/-1.00 diopter (D) of the attempted refraction and 35 eyes (87.5%) were within +/-1.00 D of emmetropia. The mean UCVA was 0.18 logMAR. Three eyes (7.5%) lost 2 lines of BCVA. The initial endothelial cell loss postoperatively was -4.6% (P< .01), which remained stable thereafter (P> .05). The mean IOP remained unchanged during the entire follow-up (P> .05). The most frequent complication was postoperative pupillary block in 7 eyes (17.5%). Two eyes with severe glare and 1 eye with unexpected myopia and discomfort had pIOL explantation. Exchange of the pIOL was performed in 2 eyes and laser-assisted subepithelial keratectomy in 1 eye to treat unexpected postoperative myopia. No pIOL-induced glaucoma or cataract developed.

CONCLUSIONS: Refractive stability and predictability were high at the 1-year follow-up. There was no gain in corrected visual acuity. Despite 2 iridotomies performed 2 weeks preoperatively, the main complication was early pupillary block.

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