Clinical Outcomes Of Posterior Chamber Diffractive Implantable Phakic Contact Lens In The Correction Of Myopia And Presbyopia

The purpose is to present our clinical outcomes of posterior chamber diffractive implantable phakic contact lens (IPCL) surgery in the correction of myopia and presbyopia in terms of functional, refractive and anatomical results, as well as safety and complications.

The sample population corresponded to patients that consulted for refractive surgery in the Refractive Surgery Department of Institut Català de Retina in Barcelona to whom implantation of IPCL was performed between November 2015 and February 2022.

A prospective non-randomized case-series study was performed on 68 myopic eyes of 34 patients who had undergone diffractive IPCL surgery. Corneal endothelial cell density (ECD), central corneal thickness (CCT), intra-ocular pressure (IOP), vault, uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), spherical equivalent (SE) and contrast sensitivity, were all evaluated. The presence of cataracts was evaluated by slit-lamp and anterior segment optical coherence tomography during postoperative follow-up.


Mean age was 47,9 ± 2.9 years-old. Mean SE decreased from -6,3 ± 2.8 D in a pre-operative stage to -0.2 ± 0.3 D twelve months after surgery. Achieved UDVA was 0,9 ± 0,2 (decimal) at 12 months. Achieved UNVA was Jaeger 1 ± 2,4 at 12 months. Vault was between 200 and 800 µm in 100% of cases 12 months after surgery. There were no intraoperative complications. Four postoperative complications appeared: one toric lens rotation, one IPCL exchange for higher addition, one small residual refractive error treated with photorefractive keratectomy and one cataract development in a high myopic patient.


Diffractive IPCL was implanted safely. Corneal endothelial CD, CCT, vault, and IOP remained stable five years after surgery. Results showed high quality uncorrected distance and near visual acuities. Presbyopic phakic lens implantation is a valid option for the correction of myopia and presbyopia allowing crystalline lens preservation and avoiding the risk of retinal detachment associated with crystalline lens surgery in myopic patients.