Long-term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation

Arturo Gomez-Bastar, Martha Jaimes, Enrique O Graue-Hernández, Tito Ramirez-Luquin, Arturo Ramirez-Miranda, Alejandro Navas, Arturo Gomez-Bastar, Martha Jaimes, Enrique O Graue-Hernández, Tito Ramirez-Luquin, Arturo Ramirez-Miranda, Alejandro Navas

Abstract

To report the long-term refractive outcomes, safety, predictability, efficacy and complications of 349 eyes treated with posterior chamber phakic intraocular lenses (pIOLs). A retrospective review of consecutive clinical cases of patients who underwent spheric implantable collamer lens (ICL) and toric ICL (TICL) implantation. The study included 349 eyes of 216 patients with sphere between +8 to -24 diopters (D) and 0 to -6.5 D of astigmatism. Statistical analysis was performed to identify differences between preoperative and postoperative refractive outcomes. Main outcome measures were preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical errors and spherical equivalent and significant postoperative complications. 194 eyes were treated with TICL and 155 eyes with ICL. The mean age of the patients was 29 ± 6.7 years. The mean preoperative sphere was -10.35 ± 5.1 D (+8 to -24) and the postoperative sphere was -0.09 ± 1.06 D (+3.25 to -6.5), p < 0.001. Preoperative cylinder was -2.63 ± 1.44 (0 to -6.5 D) and postoperative cylinder was -0.97 ± 0.89 D (0 to -3.5), p < 0.001. The preoperative mean spherical equivalent was -11.6 ± 5.12 D (+7.875 to -25.625) and postoperative spherical equivalent was -0.52 ± 1.03 (+2.25 to -6.75), p < 0.001. The mean preoperative UDVA was 1.72 ± 0.49 and postoperative UDVA was 0.23 ± 0.22, p < 0.001. The mean preoperative CDVA was 0.21 ± 0.17 and postoperative CDVA was 0.12 ± 0.138, p < 0.001. The implantation of posterior chamber pIOLs is a safe, predictable and effective strategy to manage refractive errors during long-term follow-up.

Figures

Fig. 1
Fig. 1
a Preoperative and postoperative spherical equivalent in patients treated with ICL implantation. b Pre- and post-operative UDVA (p < 0.001) and CDVA (p < 0.001) in patients treated with toric and spheric ICL implantation
Fig. 2
Fig. 2
a Safety of the procedure. After the procedure, 92.55 % of patients had no change or gain in CDVA with the procedure. b Efficacy of the procedure. 76.5 % of patients achieved a postoperative UDVA of ≥20/40. c Predictability of the procedure with 98.10 % of correlation (R = 0.9625) between the attempted and the achieved spherical equivalent refraction. d Refractive accuracy of the procedure, with 59.27 % of patients within ± 0.5 D of residual error and 78.7 % within ± 1D of residual error. e Pre- and post-operative astigmatism (p < 0.001) in patients treated with toric and spheric ICL. f Astigmatism in patients treated with a TICL. The mean astigmatism correction with this IOL model was 74.9 %
Fig. 3
Fig. 3
Lens and non-lens-related complications. a TASS syndrome, b hypopion in endophthalmitis, c TICL luxation after blunt ocular trauma and d focal anterior subcapsular cataract

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Source: PubMed

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