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Refractive outcomes and safety of phakic intraocular lens implantation in patients with anterior chamber depth between 2.8-3mm and superior to 3mm

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Session Details

Session Title: Phakic IOLs I

Session Date/Time: Monday 07/09/2015 | 14:30-16:30

Paper Time: 14:36

Venue: Room 10

First Author: : M.Guerra PORTUGAL

Co Author(s): :    A. Silva   S. Marques   J. Povoa   C. Lobo   J. Murta        

Abstract Details


Phakic intraocular lens (PIOL) implantation is very effective in the correction of high myopia, resulting in UCVA improvement. Anterior chamber depth (ACD) and endothelial cell count (ECC) are fundamental criteria to decide whether a PIOL should be implanted. In this study, we compare endothelial cell variation after PIOL implantation to treat high myopia in patients with pre-operative ACD between 2.8 and 3 millimetres and superior to 3 millimetres. Analysis of the global visual and refractive outcomes is performed.


Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.


Retrospective case-series study. High myopic patients submitted to primary PIOL implantation between January 2009 and December 2014 were reviewed. Patients with follow-up less than 6 months or history of other ophthalmological surgery were excluded. Pre and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, ACD (endothelial surface) obtained with Orbscan IIz® system and ECC were collected. Eyes were divided in two groups, according to ACD: group A – ACD between 2.8 and 3 millimetres; group B – ACD superior or equal than 3 millimetres. Comparative results between different groups of PIOL will be presented.


357 eyes of 210 patients were included. In group A, postoperative UCVA was superior or equal to 0,10 logMAR in 78% of the eyes. Spherical equivalent (SE) improved significantly (-12.0±3.8D versus -0.6±0.3D). Mean annual endothelial cell loss was 2.3%. In group B, postoperative UCVA also improved, being superior or equal to 0,10 logMAR in 73% of the eyes. SE improved significantly (-12.0±2.7D versus -0.11±0.3D). Mean annual endothelial cell loss was 0.1%. After 27±11 months follow-up, difference in endothelial cell loss was not statistically significant (p=0.323).


The present study showed that endothelial cell decrease rate after phakic IOL implantation is higher in patients with shallower anterior chambers (2.8-3mm). Although not statistically significant, an ACD higher than 3mm should be strictly respected.

Financial Interest:


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