Multifocal phakic IOL an option for hyperopia

MUNICH, Germany — A multifocal phakic IOL can be an efficient, potentially reversible refractive surgical option for patients with hyperopia, according to a presentation here.

Georges Baikoff, MD, spoke on the use of a bifocal anterior chamber phakic IOLs at the European Society of Cataract and Refractive Surgeons meeting. He shared the results of his personal study using the lens during a symposium on hyperopia.

In his study, 55 eyes of 33 patients were implanted with a bifocal phakic IOL. Nine eyes were myopic and 46 eyes were hyperopic. Follow-up ranged between 2 and 20 months.

Patients all had anterior chamber depths greater than 3.1 mm and no anterior segment disease.

Mean refraction decreased from +1.8 D preoperatively to –0.12 D postop. Mean postop uncorrected visual acuity was 0.78, and 84% of patients were 20/30 or better and could read J1 or J2.

Dr. Baikoff noted that one lens was explanted due to displeasure with intermediate vision and three were explanted due to poor near vision.

He said there was some incidence of glare and halos, but these were accepted by patients. There was also an acceptable loss of contrast sensitivity compared to preop, he said.

“It is mandatory to tell patients that this is a compromise between excellent vision with spectacles and good vision with the IOL,” Dr. Baikoff said.

He noted that in using anterior chamber phakic IOLs, accurate biometry is necessary to ensure that patients have sufficient anterior chamber depths. Shallow anterior chambers are prone to angle closure, and there is risk of endothelial cell loss, he said.