Presbyopic phakic lens performs well at 5 years
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FRANKFURT, Germany — Five-year outcomes with the presbyopic phakic IPCL from EyeOL UK show good and stable vision for distance and near.
“This is an excellent indication for myopes over 35 years, so we really don’t need to wait all the way until the age of presbyopia,” Pavel Stodulka, MD, PhD, said at the ESCRS winter meeting.
In 36 myopic eyes, a lens with +3 D near addition was implanted through a 1.8- to 2.2-mm incision. The procedure was carried out without the use of ophthalmic viscosurgical devices (OVDs) and pharmacological miosis.
“If you fold the IOL optic up, then only the thin haptics are gently touching the natural lens. There is no need to protect the endothelium with OVDs if you inject properly, and the lens is stable in the sulcus with no need for miosis. It is easier, cheaper and requires less manipulation,” Stodulka said.
Mean refraction decreased from –6.91 D to –0.52 D. Uncorrected distance visual acuity improved from 20/400 to 20/25 at 5 years, with 67% of the eyes achieving 20/25 or better and 78% of the eyes achieving at least 20/32. Corrected distance visual acuity was 20/20 or better in 88% of the eyes at 5 years. About 77% of the eyes were able to read J1 at 1 year. At 5 years, this dropped slightly to 66%, but 90% of the eyes were still reading J4. The cell count was stable, and no IOP increase was reported.
Subjective satisfaction was high. All patients said they would repeat their surgery and recommend it to their friends. About 90% see halos and glare but consider it minimally disturbing.
“Probably their natural lens filters the disturbances of these diffractive patterns, so they don’t suffer that as much as our refractive lens exchange patients do,” Stodulka said.
There were no cases of improper sizing or cataract, and no patient required laser enhancement due to residual refractive error.
“However, this is a small group of patients, and on a large scale, you will sooner or later run into one of these problems,” Stodulka said.
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Stodulka P. 5 years clinical outcomes of presbyopic phakic IOL implantation. Presented at: ESCRS winter meeting; Feb. 15-18, 2024; Frankfurt, Germany.
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