LONG TERM FOLLOW UP WITH I-CARE PHACIC IOLs
Résumé
Purpose: To evaluate visual quality and postoperative results as well adverse events in myopic patients undergoing I-CARE anterior chamber angle supported phakic intraocular lens (IOL) implantation. Design: A retrospective, nonrandomized, case series. Participants: Data of 29 eyes (16 patients) receiving I-CARE phakic IOL for high myopia (-11,66 ± 3,3) was analyzed. Methods: The IOLs were implanted between 2003 and 2006 at the Department of Ophthalmology, Medical University, Graz, Austria. The mean follow up was 51.7 ± 16 months (17 - 78 months). Main Outcome Measures: We measured uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA); patients underwent, slit-lamp examination, corneal topography, Scheimpflug imaging and measurement of endothelial cells (EC). Results: Mean UCVA and BCSVA were 0.63 and 0.94 decimal after one year. Endothelial cell loss was the most serious adverse event observed. Mean EC loss was 2%, 9%, 17%, 21%, 33% and 47% after one (n=17), two (n=20), three (n=17), four (n=17), five (n=12) and six (n=3) years, respectively. Eight IOL explantations were made due to severe EC loss three to six years after implantation. Other serious complications included one patient with an Urrets-Zavalia Syndrome (1 eye). Conclusion: Implantation of the I-CARE phakic-IOL is not a safe method for the correction of high myopia due to a serious endothelial cell loss, that might occur in a high number of patients. Patients with these IOLs should be followed up at least every 6 months and the IOL should be explanted, once the EC count drops to less than 2000 cells/mm2.
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