ICL appears safe in myopic Asian eyes with 1-year follow-up

A posterior chamber phakic IOL appears to be safe in myopic Asian eyes, despite an increase in pigment in the trabecular meshwork, a South Korean study found.

Yeoun Sook Chun, MD, and colleagues at Chung-Ang University Yongsan Hospital in Seoul examined changes in IOP, laser iridotomy sites, angle structures and pupil diameter after implantation of the Visian ICL Version 4 (STAAR Surgical) in 81 eyes of 43 patients. All patients had spherical equivalent greater than –6 D. The patients were followed for 1 year after implantation of the lens.

At 1 week and 1 month postop, the researchers observed a temporary increase in IOP caused by the use of steroid eye drops. IOP returned to preoperative levels and remained there at 1-year follow-up, according to the study.

At 1 and 3 months' follow-up, there was a significant decrease in pupil diameter, which also returned to preoperative size by 6 months postop, the authors said.

At 6 months after ICL implantation, 10 eyes (12.3%) experienced occlusion or narrowing of the laser iridotomy site by 50% or more. The iridocorneal angle width was greater than 30? in all eyes before ICL implantation but narrowed to less than 20? in 16 eyes (19.8%) at 6 months' follow-up.

In five eyes the iridocorneal angle narrowed to grade 1. Three of these eyes had laser iridotomy problems and two had slightly oversized ICLs, the authors noted.

"Laser iridotomy and adequate ICL size are important to prevent angle-closure glaucoma and pigmentary glaucoma," they said.

The researchers also observed a temporary increase in pigment in all quadrants of the trabecular meshwork as a result of ICL rubbing against irides or the iridotomy. However, pigment gradually decreased to pre-iridotomy levels by 12 months' follow-up, and no eyes developed pigment dispersion syndrome or pigmentary glaucoma, according to the study.

The study is published in the September issue of the Journal of Cataract & Refractive Surgery.