Phakic IOL a promising alternative to laser surgery for myopic US military personnel

J Refract Surg. 2011;27(7):473-481.

Phakic IOL implantation yielded strong outcomes in active military personnel with myopia deemed unsuitable for laser vision correction, a study found.

“To our knowledge, it is the first report of myopic phakic intraocular lenses in a military population,” the study authors said. “Although long-term follow-up may be necessary to determine the appropriate role for phakic IOLs in warfighters, evaluation of early outcomes provides useful information about the potential for this treatment option.”

The retrospective study included 135 eyes of 69 patients who underwent implantation of the Visian Implantable Collamer Lens (STAAR Surgical) over a 14-month interval in 2008 and 2009.

Indications for ICL implantation were abnormal corneal topography in 37% of eyes, thin predicted post-LASIK residual stromal bed in 32%, history of dry eye disease in 13%, thin central corneas in 11% and other conditions in 7%.

Mean patient age was 30.9 years. Analysis of 3-month postoperative outcomes included 128 eyes.

Mean preoperative spherical equivalent refraction was –6 D, and mean preoperative astigmatism was 0.65 D. Mean preoperative logMAR corrected distance visual acuity was –0.08 D (Snellen equivalent, 20/16.6).

Mean targeted spherical equivalent refraction was –0.21 D. Study results showed that mean postoperative spherical equivalent refraction was –0.19 D. Refractive correction was within 0.5 D of emmetropia in 90% of eyes and within 0.75 D in 99%.

Mean postoperative logMAR corrected distance visual acuity was –0.13 (Snellen equivalent 20/14.8); 33% of eyes gained at least one line of corrected distance visual acuity and 13% gained at least two lines. One eye lost one line. No eyes lost two or more lines.

Results showed no significant intraoperative or postoperative complications.