Posterior chamber phakic intraocular lens implantation for high myopia

AIM: To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia. METHODS: Retrospective case review of 82 eyes (43 patients) undergoing implantable Collamer lens (ICL) placement by a single surgeon (Xiao-Wei Gao) to correct preoperative mean spherical equivalents between -9.00 diopter (D) and -23.00D. Main outcome measures included uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), intraocular pressure (IOP), lens transparency, postoperative uveitis. Visante anterior segment optical coherence tomography (AS-OCT) was used to measure anterior chamber depth (ACD) and the position of ICL. RESULTS: Mean follow-up was 6.54 +/- 3.26 months (range 3-12 months). Predictability of the manifest spherical equivalent (SE) refraction to within +/- 1.00D was achieved in 88% of eyes and +/- 0.50D in 72.5% of eyes. The mean postoperative manifest SE refraction was -1.85 +/- 0.72D, with 96.34% of eyes maintaining or gaining >> 1 line (s) of BSCVA. The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD. Of the 7 eyes (8.54%) with a mild transient increase in intraocular pressure (up to 30mmHg), none required a second surgical procedure or prolonged topical medication. There was no loss of lens transparency. Pigmented precipitates were observed in 5 eyes (6.09%). The mean preoperative ACD measured with AS-OCT was 3.28 +/- 0.14mm, three months after surgery, the mean ACD was 2.45 +/- 0.22mm. Anterior chamber depth showed a statistically significant reduction. One eye (1.22%) had ICL spontaneous rotation, 81 eyes (98.78%) of the lens remained correctly centered. CONCLUSION: The implantation of ICL is an effective surgical option for the management of high myopia. But its long time effect and safety still need more time to prove.