Long-time follow-up results of phakic posterior chamber intraocular lens and iris-claw phakic intraocular lens implantation for high myopia

Background

With the development of refractive surgery, phakic intraocular lens implantation (PIOL) for high myopia is proving its outstanding merits in short-term treating outcomes.However, its long-term safety and effectiveness were still in more attention.

Objective

This study was to evaluate and compare the long-term safety, stability and efficacy of Verisyse PIOL implantation with implantable contact lens (ICL) implantation for high myopia.

Methods

The clinical data of 18 eyes (9 patients) who received Verisyse iris-claw intraocular lens implantation for high myopia and matched 22 eyes (11 patients) who received ICL implantation for high myopia from 2009 to 2011 were retrospectively analyzed.The patients were followed-up for 2 years after surgery.Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalence (SE), axial length, corneal endothelial cell density (ECD), contrast sensitivity (CS), wave-front aberrations and postoperative complications were recorded during the following-up.The efficacy index, predictable and safety index were compared between the two groups.

Results

There was no significant difference in UCVA, BCVA and SE between Verisyse group and ICL group (t=0.92, 1.32, 4.32; all at P>0.05). Non-glare CS under the 1.5, 3.0, 6.0, 12.0 and 18.0 c/d spatial frequencies were insignificantly different between the two groups(Z=0.782, 0.956, 0.495, 0.874, 0.293; all at P>0.05), and the similar outcomes were found in glare CS (Z=0.985, 1.254, 0.896, 1.652, 0.492; all at P>0.05) in postoperative 2 years.Root meas square of total high order aberration (RMSh), vertical-trefoil, vertical-coma, horizontal-coma, spherical aberration(SA), were significantly elevated in the Verisyse group compared with the ICL group (Z=4.72, 4.24, 3.12, 3.65, 2.16; all at P<0.05). The mean efficacy index was 108.49±16.62 in the Verisyse group and 106.71±15.88 in the ICL group, showing a significant difference (t=0.54, P>0.05). The mean safety index was 140.56±33.89 in the Verisyse group and 143.34±34.56 in the ICL group, with a significant difference between them (t=0.29, P>0.05). The mean predictable index was -0.25(-0.97, 4.23)in the Verisyse group and 0.98 (-1.44, 1.52) in the ICL group, and the difference was significant(Z=-2.68, P<0.05).

Conclusions

Both Verisyse PIOL implantation and ICL implantation for high myopia are safe, predictable and effective.The vusial quality and predictability of ICL implantation are much better than Verisyse PIOL implantation.A long-term effect should be observed for the further evaluation.

Lens implantation, intraocular/methods; Myopia/surgery; Postoperative complications; Phakic eye; Retrospective studies; Safety; Treatment outcome, long-term