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Angle-supported phakic IOL maintains stable positioning up to 3 years postop
J Cataract Refract Surg. 2010;36(7):1120-1126.
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An angle-supported phakic IOL offered long-term stability, according to a study.
"The angle-supported foldable hydrophobic [phakic] IOL maintained adequate central clearance distances to the corneal endothelium and the natural crystalline lens over 3 years," the study authors said.
The prospective nonrandomized clinical trial included 26 eyes of 26 patients with moderate to high myopia implanted with the AcrySof Cachet (Alcon).
Investigators used Scheimpflug imaging to assess anatomic features preoperatively and at 1, 3, 6 to 12 and 24 to 36 months postoperatively. Primary outcome measures were distance between the corneal endothelium and the IOL and between the IOL and the crystalline lens. Twenty-one eyes were statistically analyzed.
Study data showed no statistically significant differences in absolute endothelium-IOL or IOL-crystalline lens distances at any follow-up point. Mean endothelium-IOL distance was 2.05 mm at 1 month and 2.15 mm at 24 to 36 months. Mean IOL-crystalline lens distance was 0.92 mm at 1 month and 0.86 mm at 24 to 36 months, results showed.
Slight changes in endothelium-IOL distance and overall calculated anterior chamber depth were statistically significant, according to a one-way t-test. A change in IOL-crystalline lens distance was statistically insignificant.
Drs. Kohnen and Klaproth use Scheimpflug photography to demonstrate that an angle-supported phakic IOL is stable and once implanted, does not appear to move either anteriorly or posteriorly. This is an important study since the long-term risks of angle-supported phakic IOLs include corneal endothelial decompensation and cataract formation. If the implant is not significantly moving either toward the cornea or lens, then the risk of continued damage from the phakic IOL should be diminished. Also, most anterior segment surgeons are already comfortable with the technique of implanting an angle-supported IOL, as compared to implanting an iris-fixated or sulcus phakic IOL. Therefore, the use of angle-supported phakic IOLs will continue to rise, and thus the safety of such IOLs needs to be fully investigated.
– Bonnie An Henderson, MD
OSN Cataract
Surgery Board Member
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