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PRL effective in high myopia patients

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Phakic refractive lens implantation is safe and effective in patients with high myopia, according to a study.

Ioannis G. Pallikaris, MD, PhD, and colleagues at University of Crete studied 34 eyes of 19 patients with myopia who were treated with phakic refractive lens (PRL) implantation. Mean patient age was 29 years. Mean preoperative spherical equivalent was –14.7 D and mean preop refractive cylinder was –2.02 D. Follow-up ranged from 12 to 24 months.

Patients were examined postoperatively at 1 day, 1 week, 1 month and 3, 6, 9 and 12 months. In their postop examinations, the study authors found that UCVA improved from counting fingers preoperatively to 0.62 ± 0.28 at the final follow-up examination (P < .001). All 34 eyes gained 1 to 12 lines. The mean difference between preop and postop UCVA was a 6.2 line gain.

Mean BCVA improved from 0.7 to 0.85 (P < .001). One eye lost two lines of preop BCVA, eight maintained pre-PRL implantation BCVA, and the remaining 25 eyes gained one to five lines.

The authors assessed wavefront aberrations in 15 eyes (44.1%). Total high-order root mean square (RMS) was calculated for pupil diameters of 5 mm and 3 mm pre-implantation and 1-year postop. Total high-order aberration for eyes with 3-mm pupil diameter did not change significantly; however, spherical aberration in 5-mm pupils was significantly decreased at 1-year postop. A small loss of contrast sensitivity was also noted after implantation.

Six patients (25.5%) reported glare and halo at night postoperatively. The symptoms decreased 6 months post-PRL implantation. The authors attributed the halo and glare to the optic zone of the PRL used in the study (5 mm). Five of the patients who complained of these symptoms had pupils greater than 7 mm, and the other patient had a 6-mm pupil. The PRL was too small in comparison to these patients’ scotopic pupil size, the authors said. Higher-order aberrations of the 15 eyes with 5-mm pupils remained unchanged.

“The decrease in spherical aberration after PRL implantation could be a benefit for mesopic vision,” the study authors said.

This study is published in the June issue of Journal of Cataract & Refractive Surgery.