Phakic refractive lens to correct moderate to high myopia five years after implantation

Resumen

PURPOSE: To assess refractive and visual outcomes five years after surgical implantation of silicone phakic refractive lenses (PRL®, Zeiss/Meditec. Jena. Germany) in moderate to high myopia. METHODS: A prospective clinical study involving 35 eyes of 20 patients (8 men, 12 women, mean age 31.83±8.87 years) implanted with PRLs was conducted. Uncorrected visual acuity (UCVA), best-distance-corrected visual acuity (BDCVA), objective and subjective refraction and intraocular pressure (IOP) were assessed before and after surgery. Mean time post-surgery was 57.34±9.24 months. Mean preoperative spherical equivalent was -10.25 D±3.19 (range -7.25 to -22.50 D). Target refraction was emmetropia in all eyes. RESULTS: Preoperative UCVA was 2.40±0.19 logMAR and mean preoperative BDCVA was 0.19±0.05LogMAR. Mean UCVA changed from 2.40±0.19 to 0.11±0.09 LogMAR after surgery (P<0.001). Postoperative UCVA was 0.3 LogMAR or better in 34 eyes (97.14%) and 0.1 LogMAR or better in 24 eyes (68.57%). Mean BDCVA changed from 0.19±0.05 to 0.2±0.09 LogMAR after surgery (P<0.001). After surgery BDCVA was 0.2 LogMAR or better in 34 eyes (97.14%) and 0.1 LogMAR or better in 30 eyes (85.71%). Overall efficacy index was 1.09. Fourteen eyes gained more than 2 lines of BDCVA. Safety index was 1.29. After surgery, all eyes were within ±1.00D and 32 (91.43%) within ±0.50D of targeted refraction. CONCLUSIONS: Present results suggest correction of moderate to high myopia by means of PRL implantation safe, effective and predictable after five years. Candidate selection seems crucial for avoiding the presence of undesirable complications such as zonular dehiscence or cataract.