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Safety, visual outcome and complications of bilateral sequential phakic intraocular implantation on the same day for myopic eyes in a tertiary eye care centre in urban Indian population

Poster Details

First Author: N.Solanki INDIA

Co Author(s):    P. Solanki   S. K R   H. Adusumilli              

Abstract Details

Purpose:

To study the safety outcomes best corrected visual acuity(BCVA), intraocular pressure (IOP) and complications ( corneal edema, cataract, lens capsule tear, anterior chamber(AC) inflammation and endophthalmitis ), after bilateral simultaneous Phakic Intra ocular lens implantation (IOL) in myopic eyes in immediate post operative period and at the end of 3 months in Indian urban population.

Setting:

Teritiary eye care centre in Bangalore, India (Urban population)

Methods:

34 patients with a myopia ranging -5.0 D to – 22.5 D who underwent bilateral phakic Intra ocular lens (STAAR or IOCARE) in the same sitting by same surgeon were analyzed retrospectively for BCVA, IOP, Average keratometry (K), Anterior chamber depth (ACD) and recording of any adverse events (AV) like corneal edema, Descemet’s fold, exacerbated inflammation, and endophthalmitis etc. in immediate post operative period and 3 month follow up. Screening criteria including a refraction, topography, dilated retinal evaluation, dilated retinoscopy, pachymetry, IOP was done before selecting patients for the procedure. The data was analyzed using Microsoft excel software.

Results:

34 were analyzed (Age 19- 35 years: M 12, F 22 myopia -5D to – 22.5D. 16 underwent ICL (STAAR), 2 toric ICL and 16 IPCL (IOCARE). Pre op BCVA was 0.0 – 0.6 LogMAR, average ACD RE 3.22 mm, LE 3.20 mm. Post operative BCVA: 0.0 – 0.6 LogMAR. Residual refraction - range of 0.5 – 3.0 D. Five had transient raise in IOP, controlled by medical management, 1 underwent laser iridotomy for pupillary block. Other AV’s corneal edema (2), AC inflammation in the immediate post operative period (3), lens capsule tear (0), visually significant cataract (0) , endophthalmitis (0) or explantation (0) were noted

Conclusions:

Bilateral sequential phakic Intra ocular implantation on same day appears to be safe alternative in terms of BCVA, IOP, inflammation, endophthalmitis, and development of Cataract in our study. Same day provides faster recovery, fewer visits to hospital, similar medication schedule, fewer leaves from work. However short follow is a limitation. In present era of immediately sequential bilateral cataract surgery , bilateral sequential phakic IOL implantation has better safety due to lack of breach in blood retinal barrier and no trigger of anterior chamber associated immune response, and could be a novel option in terms of safety and retaining binocular vision.

Financial Disclosure:

NONE

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