Fluorophotometry in Myopic Phakic Eyes With Anterior Chamber Intraocular Lenses to Correct Severe Myopia

Implanting an anterior chamber intraocular lens in a phakic eye is an effective surgical procedure for the correction of severe myopia. However, the potential risks on the anterior segment structures are scarcely known. We conducted a prospective study to evaluate the permeability of the blood-aqueous barrier and the lens transmittance changes after Worst-Fechner lenses were implanted to correct myopia. Preoperative and serial postoperative fluorophotometry was done in 15 eyes that had a Worst-Fechner lens implanted to correct myopia. Lens transmittance was evaluated by lens autofluorescence, and permeability of the blood-aqueous barrier was estimated by anterior vitreous fluorophotometry, which was carried out before and after intravenous injection of fluorescein. Preoperative lens transmittance was 0.971 ± 0.002 (mean ± standard error), and, after the operation, lens transmittance decreased to 0.970 ± 0.002 at one month, 0.966 ± 0.001 at three months, 0.964 ± 0.002 at six months, and 0.962 ± 0.003 at 14 months. At three, six, and 14 months after the operation, lens transmittance values were significantly lower than preoperative values (P = .038 at three months, P < .001 at six months, and P = .005 at 14 months). Fluorescein concentration in the anterior vitreous was 18.522 ± 1.797 ng/ml (mean ± standard error) preoperatively and was 21.328 ± 1.667 ng/ml at one month, 27.518 ± 1.412 ng/ml at three months, 27.150 ± 1.474 ng/ml at six months, and 27.012 ± 1.980 ng/ml at 14 months postoperatively. At three, six, and 14 months after the operation, fluorescein concentration was significantly higher than preoperative values (P < .001 at three and six months and P = .036 at 14 months). Our study shows a decrease in lens transmittance and a prolonged breakdown in the blood-aqueous barrier after Worst-Fechner lenses were implanted.