Choroidal neovascularization in phakic eyes with anterior chamber intraocular lenses to correct high myopia

To analyze the appearance, incidence, and characteristics of choroidal neovascularization (CNV) in patients with high myopia corrected by implantation of a phakic anterior chamber intraocular lens (PACL) University Miguel Hernández, Instituto Oftalmológico de Alicante, Alicante, Spain. The CNV observed in 294 consecutive eyes (181 patients) implanted with a PACL for the correction of high myopia (–7.0 to −38.0 diopters) was studied. The mean follow-up was 50.6 months ± 32.8 (SD) (range 6 to 120 months). Choroidal neovascularization occurred in 5 eyes (1.70%); 3 eyes were in women, and 2 were in men. The interval between PACL implantation and CNV was 63.2 ± 27.3 months (range 18 to 87 months). The CNV was subfoveal in 4 eyes and juxtafoveal in 1 case. The mean best spectacle-corrected visual acuity (BSCVA) after PACL implantation and before the appearance of CNV was 0.53 ± 0.18 (range 0.4 [20/50] to 0.8 [20/25]); after CNV appeared, it was 0.26 ± 0.18 (range 0.05 [20/400] to 0.5 [20/40]), a statistically significant difference ( P = .001, paired Student t test). In 2 cases, the CNV was treated with photodynamic therapy (PDT); in the other 3 cases, PDT was rejected. The cumulative risk for CNV (Kaplan-Meier survival analysis) in highly myopic patients corrected by PACL implantation was 0.43% at 18 months and 5.4% at 87 months. Implantation of a PACL to correct high myopia was followed by a small incidence of CNV (cumulative risk of 5.4% at 87 months). The appearance of CNV was followed by a significant decrease in BSCVA.