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IOP after anterior chamber phakic IOL implantation
Session Title: Phakic IOL Implantation I
Session Date/Time: Tuesday 08/10/2013 | 14:00-16:00
Paper Time: 15:42
Venue: Main Lecture Hall (Ground Floor)
First Author: : M.Freitas PORTUGAL
Co Author(s): : A. Marinho
To evaluate the evolution of IOP after Artiflex phakic IOL and Acrysof Cachet phakic IOL implantation. To evaluate the risk of OHT/glaucoma peri and post operative and which mechanisms could be envolved.
Hospital Arrįbida, Porto Portugal
There are two groups of patients implanted with two kinds of anterior chamber phakic IOL. All the eyes were implanted by the same surgeon (A. Marinho). Group A: 88 eyes with myopia were implanted with Artiflex phakic IOL between 2005 -2007 and the results consider a follow-up minimum of 60 months. Oral steroids were prescribed during 9 days and topic steroids during 4 to 6 weeks. Group B: 120 eyes with myopia were implanted with Acrysof Cachet phakic IOL between 2008-2012 and the results consider a follow-up minimum of 6 months. Topic steroids were prescribed during 2 weeks. In Group B the eyes were then divided in three groups according to IOL compression (difference between the size of IOL and anterior chamber diameter): Group B.1.: compression < 1mm; Group B.2.: compression = 1mm and Group B.3.: compression > 1mm. IOP was measured by Goldmann applanation tonometer. Before surgery, 1st day, 1,3, 12, 18, 36 and 60th months IOP was evaluated.
Group A: The mean IOP was 15.57±2.10mmHg, before surgery and1st day, 1, 12, 36 and 60th months, respectively: 16.00±2.30; 17.70± 5.11; 15.93±2.07; 14.66±1.97 and 16.32±3.77 mmHg. None developed pupillary block, OHT related with viscoelastic, pigment dispersion syndrome or angle closure OHT. 10 eyes (11.36%) developed IOP>21mmHg after steroids treatment. All OHT but three eyes normalised after stopping steroids treatment. Those eyes are at the moment controlled with drops. No glaucoma surgery was needed. Group B: Considering all eyes, the mean IOP was 14.33 ± 2.9; 14.34 ± 2.06; 14.47±2.05; 14.64±1.65 and 14.92±1.92, before surgery, at day one, 1, 3 and 18 months, respectively. In Group B.1., the mean IOP was 15.38±1.46; 15.16± 1.54; 15.33±2.06; 14.78±1.30 and 13.67±3.21, before surgery, at day one, 1, 3 and 18 months, respectively. In Group B.2., the mean IOP was 14.70 ±1.83; 14.88±2.01; 15.03±2.00; 14.88±1.53 and 15.00±1.58, before surgery, at day one, 1, 3 and 18 months, respectively. In Group B.3., the mean IOP was 13.93 ±2.37; 13.81±2.12; 13.94±1.95; 14.08±1.85 and 14.82±2.21, before surgery, at day one, 1, 3 and 18 months, respectively. These differences are not statistically significant. None developed pupillary block, OHT related with viscoelastic material, pigment dispersion syndrome or angle closure OHT.
Artiflex phakic IOL are safe in concerning IOP. Acrysof Cachet phakic IOL implantation does not change IOP throughout the follow-up and the IOL compression does not influence the IOP in this series.
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