Phakic posterior chamber lenses for high myopia: functional and anatomical outcomes

To evaluate the functional and the anatomical outcomes after implantation of phakic posterior chamber intraocular lenses (IOLs) in highly myopic eyes. Service d’Ophtalmologie, Hopital Purpan, Toulouse, France. Fifty-eight eyes of 46 patients that had implantation of phakic posterior chamber lenses for high myopia were evaluated. Predictability, efficiency, safety, and subjective and objective quality of vision were evaluated preoperatively and at least 6 months postoperatively. The effect of the procedure on the cornea, aqueous humor, pupil, anterior chamber angle, crystalline lens, and retina were studied. Mean preoperative myopia was −13.85 diopters (D) ± 3.1 (SD) (range −8.00 to −19.25 D). Mean postoperative spherical equivalent was −1.22 ± 0.83 D (range +0.75 to −3.50 D); 56.9% of eyes were within ±1.00 D of the predicted result, and 77.6% gained 1 or more lines of best corrected visual acuity. All contact-lens-intolerant patients had improved quality of vision for day and night driving, distance vision, and vision under dim illumination. The mean postoperative level of contrast sensitivity without correction was higher than the mean preoperative level with correction. Adverse events were 2 cases of crystalline lens opacification 16 and 18 months after surgery and 2 cases of pigment deposits in the angle with increased intraocular pressure, which was controlled by beta-blockers. Implantation of posterior chamber phakic IOLs is effective and predictable; however, long-term follow-up is needed.