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Long-term follow-up of anterior chamber phakic AcrySof Cachet intraocular lens implantation for moderate to high myopia

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Session Details

Session Title: Phakic IOLs I

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

Paper Time: 15:06

Venue: Room 10

First Author: : M.Bechmann GERMANY

Co Author(s): :    W. Mayer   T. Kohnen   R. Wiltfang   D. Kook           

Abstract Details


To assess safety of long-term clinical outcomes of an foldable angle-supported phakic intraocular lens (AcrySof Cachet, Alcon) implantation for moderate to high myopia.


Retrospective observational case series.


We evaluated the follow-up of 321 eyes of 169 patients with myopia of –5.0 to – 15.0 diopters who underwent uneventful anterior chamber phakic AcrySof Cachet implantation by one single surgeon (MB) in two surgical centers in the period of 2009 – 2014. Following parameters were assessed before surgery: sex, age, refraction, CDVA, biomicroscopy, tomography revealing anterior chamber depth and iridocorneal angle, corneal endothelial cell density, white-to-white and size of Cachet implanted. During follow-up at 1, 2, 3, 4 and 5 years after surgery, following parameters were assessed: refraction, corneal endothelial cell density and postoperative complications based on biomicroscopy findings.


The mean preoperative corneal endothelial cell count was 2655, 2580 after 1 year, 2593 after 2 years, 2571 after 3 years and 2374 after 4 years (p < 0.03) (mean 2,65 % of EC loss per year). In 10 eyes, AcrySof Cachet IOL was explanted due to following reasons: severe pupil ovalisation with peripheral anterior synechia (4 eyes) and Cachet had to be exchanged due to decentration caused by sizing error (6 eyes). No Cachet had to be exchanged due to corneal endothelial cell loss.


Our retrospective study shows good safety and results after AcrySof phakic IOL implantation. However, annual corneal endothelial cell count is mandatory as cell loss may occur. We found pupil ovalisation with peripheral anterior synechia as an adverse event with this kind of phakic IOL. Indications for postoperative explantation of Acrysof Cachet phakic IOL in our patient collective were sizing error and pupil ovalisation but not corneal endothelial cell loss.

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