Medium-term visual, refractive, and intraocular stability after implantation of a posterior chamber phakic intraocular lens to correct moderate to high myopia

PURPOSE: To evaluate the medium-term refractive and visual outcomes and the complications after implantation of a silicone posterior chamber phakic intraocular lens (PC pIOL) for moderate to high myopia. SETTING: Oftalmar, Medimar International Hospital, Alicante, Spain. DESIGN: Retrospective case series. METHODS: Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, and intraocular pressure were evaluated during a medium-term follow-up. Postoperative complications were also studied. RESULTS: The study enrolled 35 eyes (mean preoperative spherical equivalent [SE] -10.25 diopters [D] +/- 3.19 [SD]) of 20 patients with a mean age of 31.83 +/- 8.87 years and a mean follow-up of 57.34 +/- 9.24 months. The mean UDVA improved from 2.40 +/- 0.20 logMAR preoperatively to 0.08 +/- 0.13 logMAR at the last postoperative visit (P<.01). The mean CDVA improved from 0.11 +/- 0.09 logMAR to 0.02 +/- 0.09 logMAR, respectively (P<.01). The postoperative CDVA was 0.1 or better in 30 eyes (85.71%), with 22 eyes (62.86%) gaining lines of CDVA. The final efficacy index was 1.16 and the final safety index, 1.26. Regarding predictability, 34 eyes (97.14%) had an SE within +/- 1.00 D and 33 eyes (94.28%) within +/- 0.50 D. The complications were PC pIOL decentration (2 eyes, 5.71%), cortical lens opacification (1 eye, 2.86%), and retinal detachment (1 eye, 2.86%). CONCLUSIONS: Implantation of a PC pIOL to correct moderate to high myopia was efficient and predictable in the medium term, with intraocular stability in most cases. New designs and criteria for PC pIOL size selection should be developed.