Relevance Of Cysts In The Sulcus, In Patients With Posterior Chamber Phakic Lens

There is a high prevalence of cysts detected in the iridociliary sulcus in myopic patients undergoing preoperative evaluation for posterior chamber phakic intraocular lenses (PIOLs). The controversy lies in defining when this is a surgical contraindication. In this work, the obtained vaults, intraocular pressure (IOP), and the occurrence of complications were evaluated in operated patients with cysts.

Clínica de Ojos Dr Nano, Olivos (Buenos Aires) Argentina.

A single-center prospective case-series study was performed, including myopic patients who underwent surgery with posterior chamber PIOLs (IPCL; Care Group, India), between January and December 2022, at the Dr. Nano Eye Clinic (Olivos, Argentina). Preoperatively, the spherical equivalent (SE) was evaluated and the sulcus anatomy was assessed by biomicroscopic ultrasound. The eyes were divided into two groups, in relation to the presence (group A) or absence (group B) of cysts in the iridociliary sulcus. Postoperative vault, IOP, and the occurrence of complications were evaluated, one and three months after surgery. Results were compared in each group between follow-up (a and 3 months) and between both groups.

A total of 102 eyes of 72 patients were included. The mean preoperative SE value was -11.44 ±5.1D. Cysts were detected in 48 eyes. The mean vault in group A was: 380 ±190 mcs and 398 ±192 mcs, (1 - 3 months postop respectively; p: 0.25). In group B, vault was 420 ±212 mcs and, 415 ±221 mcs, (1 - 3 months postop respectively; p: 0.37). Between groups, the difference was p: 0.15 and 0.24 respectively. Mean IOP in group A 13.8 ±2.2 mmHg and 13.4 ±1.9 mmHg, 1 and 3 months after surgery respectively (p: 0.48). Mean IOP in group B was 13.5 ±1.6 mmHg and 13.6 ±1.5, 1 and 3 months after surgery respectively (p: 0.51). Between groups, differences were: p: 0.49 and 0.50 respectively). No cataracts or other complications were detected in any group.

In the present series, we did not find complications or a statistically significant difference in the post-operative vault and IOP obtained in eyes, with or without cysts, implanted with IPCL PIOLs at different follow-up times.