Phakic IOL improves visual acuity, offers spectacle independence for high myopes

J Cataract Refract Surg. 2011;37(8):1426-1433.

Implantation of a phakic IOL yielded positive visual outcomes, high patient satisfaction and freedom from corrective lenses, a study found.

Patients underwent bilateral implantation of the AcrySof Cachet phakic IOL (Alcon) for high myopia.

“Bilateral implantation of the AcrySof Cachet [phakic] IOL improved highly myopic patients’ quality of life by significantly improving visual acuity and reducing dependency on corrective lenses,” the study authors said.

The IOL is a single-piece, foldable acrylic implant with an ultraviolet chromophore inserted into the anterior chamber angle. Three models of the implant were used in the study.

The pooled analysis of two non-randomized clinical trials included 138 patients. Mean patient age was 37 years.

Binocular uncorrected and corrected distance visual acuity, patient satisfaction, spectacle independence and Refractive Status and Vision Profile questionnaire scores were assessed at baseline and at 6 months, 1 year and 2 years postoperatively. Refractive Status and Vision Profile scores were ranked on a scale of 1 (low) to 5 (high).

Mean preoperative uncorrected distance visual acuity was worse than 20/400, or counting fingers. Mean baseline logMAR corrected distance visual acuity was –0.06, or about 20/20.

Study results at 2 years showed that mean logMAR uncorrected distance visual acuity was –0.12, or 20/15. Mean logMAR corrected distance visual acuity was –0.18, or about 20/15.

Mean postoperative uncorrected distance visual acuity at 2 years was statistically significantly better than mean preoperative corrected distance visual acuity, the authors said.

Refractive Status and Vision Profile scores for patient satisfaction with uncorrected distance visual acuity were 1.1 at baseline, 4.3 at 6 months and 1 year, and 4.4 at 2 years.

Dependence on corrective lenses was 100% at baseline and 26% at 2 years, the authors reported.