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Good results seen with phakic IOL in eyes with moderate to high myopia
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A new-generation posterior chamber phakic IOL corrected moderate to high myopia, according to a study.
The prospective study included 138 eyes of 70 patients with a mean age of 30.5 years who were implanted with the V4c Visian Implantable Collamer Lens (STAAR Surgical), which has a central hole to facilitate aqueous outflow and eliminate iridotomy and iridectomy. All patients had myopia between 0.5 D and 18 D.
Mean spherical equivalent decreased to –0.03 D at 6 months postoperatively from –8.73 D preoperatively. Refraction was within 0.5 D of the target in 98.5% of eyes and within 1 D in all eyes.
Mean uncorrected distance visual acuity was 20/20 or better in 92.1% of eyes, and mean corrected distance visual acuity was 20/20 or better in 95% of eyes at 6 months.
Mean logMAR uncorrected distance visual acuity improved significantly from before surgery to 6 months after surgery (P < .0001). Mean corrected distance visual acuity also improved significantly (P < .05). Twenty-five eyes gained lines, 113 eyes had no change, and no eyes lost any lines.
Mean postoperative vault was 482.7 µm at 6 months; mean vault decreased over time (P < .0001). Mean endothelial cell loss was significant, at 8.5% (P < .0001).
Postoperative IOP remained consistent throughout the follow-up period.
No intraoperative or postoperative complications were reported.
Perspective
Back to TopJorge L. Alió, MD, PhD
The authors have evaluated the refractive outcome obtained with a new model of posterior chamber implantable collamer lens for the correction of myopia.
In this study, they demonstrate that this lens is similar to the previous recent models of this phakic IOL in terms of refractive predictability. The main difference was the absence of peripheral iridotomy-iridectomy, not necessary with this new model providing that it has a central hole opening of 0.36-mm called the KS-Aquaport. This is the main feature that involves this ICL V4c phakic IOL model correcting the previous one. It is not surprising that the outcomes are similar to the previous model in terms of refraction and indeed this article proves that the KS-Aquaport is effective in preventing pupilar blockade that could otherwise happen with this lens model.
The main limitation of this study is that the authors have not performed an evaluation of the scattering of light that happens in this model as the hole is central and supposedly it should interfere with light entering in the visual axis. Further investigations with devices such as the ocular quality assessment system or a straylight will for sure be performed in the future in order to ascertain whether light interference happens or not because of the central opening that exists in this phakic IOL model.
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