Angle-supported phakic intraocular lenses for the correction of myopia: Three-year follow-up.

Purpose To evaluate patient safety and refractive outcomes in eyes with an angle-supported phakic intraocular lens (pIOL), and to assess the correlation between rotation and corneal endothelial cell damage. Setting Gimbel Eye Centres, Calgary and Edmonton, Alberta, Canada. Design Retrospective cohort study. Methods This study included patients with moderate to high myopia (range −6.50 to −19.50 diopters [D]) who received the Acrysof Cachet pIOL. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity, manifest refraction spherical equivalent (MRSE), endothelial cell density (ECD), and IOL rotation. Results This study evaluated 119 eyes of 61 patients. The mean ECD decrease from preoperative measurements was 3.11% (n = 46), with a mean IOL rotation of 10.6 degrees (n = 35) at the 3-year postoperative visit. Of the 49 eyes at the 3-year visit measured for UDVA, 98.0% were 20/40 or better and 77.6% were 20/20 or better. The MRSE improved from a preoperative mean of −9.26 diopters (D) ± 2.43 (SD) (range −19.50 to −5.63 D) to −0.33 ± 0.61 D (range −3.12 to +0.71 D) at the 3-year visit. The residual refractive error was within ±0.50 D of the target refraction for 78.4% and within ±1.00 D for 92.2% of the 51 eyes. The study included one bilateral pIOL removal due to endothelial cell loss, one case of synechia, and one case of subtle pupil ovalization. Conclusions No correlation between IOL rotation and ECD decrease was found ( R 2 = 0.0143); the pIOL provided promising refractive outcomes and acceptable safety in patients with moderate to high myopia. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.