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Session Title: Phakic IOL Implantation I
Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00
Paper Time: 14:36
Venue: Main Lecture Hall (Ground Floor)
First Author: : M.Doors THE NETHERLANDS
Co Author(s): : A. Aerts T. Berendschot R. Nuijts
To evaluate the efficacy, safety and stability of the angle-supported Acrysof Cachet phakic intraocular lens (pIOL) to correct moderate to high myopia, and compare endothelial cell (EC) loss to EC loss after iris-fixated Artisan and Artiflex pIOL implantation.
University Eye Clinic, Maastricht University Medical Center, The Netherlands
In this prospective study, 117 eyes were included who underwent Acrysof Cachet pIOL implantation for moderate tot high myopia ranging from -6.00 to -16.5 diopters (D). Preoperatively and 6 month, 1 and 2 years postoperatively, uncorrected and best-corrected visual acuity (UCVA; BCVA), spherical equivalent (SE), EC counts and adverse events were documented. Furthermore, we compared EC loss to EC loss after Artisan (n=369 eyes), Artiflex (n=237 eyes) and toric Artisan (n=102 eyes) implantation at 6 months, 1 year and 2 years postoperatively. All surgical procedures were performed by the same surgeon.
UCVA was 20/40 or better in 84 (100%) and 30 (100%) of eyes and 20/20 or better in 55 (65.5%) and 16 (53.3%) of eyes at 1 (n=86) and 2 (n=30) years postoperatively, respectively. BCVA was 20/32 or better in 86 (100%) and 30 (100%) of eyes and 20/20 or better in 80 (93%) and 28 (93.3%) of eyes at 1 (n=86) and 2 (n=30) years postoperatively, respectively. Mean postoperative SE was -0.29 ± 0.40D at 2 years postoperatively. Residual refractive error was within ±0.50D of intended refraction in 84% and 75%, and within ±1.00D in 98% and 94% at 1 and 2 years postoperatively, respectively. No eyes lost 2 or more lines of BCVA. Safety-index was 1.08 and 1.05 at 1 and 2 years after implantation, respectively. One patient developed pupil ovalization, which resulted in explantation of the pIOL. EC loss was 3.74 %, 5.07% and 7.36% at 6 months, 1 and 2 years postoperatively, respectively. Compared to the EC losses with the Artisan and Artiflex pIOL, the Cachet pIOL showed a significantly larger loss (P<0.05). However, when excluding the surgical loss, there were no significant differences between these 3 pIOL types in EC loss (P>0.05).
The Acrysof Cachet pIOL effectively corrects moderate to high myopia, with good predictability and stability. Concerning the safety, no eyes loss 2 or more lines of BCVA. However, acute surgical EC loss is larger with the Cachet pIOL when compared to the Artisan and Artiflex iris-fixated pIOL.
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