5 YEARS CLINICAL OUTCOMES OF PRESBYOPIC PHAKIC IOL IMPLANTATION

As the risk of dry eye increases with age, the risk of dry eye caused by laser refractive surgeries increases in presbyops. Presbyopia correcting phakic lens is an option for refractive surgery on presbyops correcting both distance and near refraction and associated with minimal risk of inducing eye dryness. We present 5 years clinical data of presbyopic IPCL (EyeolUK Ltd.) implantation. The world first presbyopic IPCL was implanted by me. This lens has trifocal diffractive rings on its anterior optic surface.

Gemini Eye Clinic, Zlin, Czech Republic

This case series study included 36 eyes (50% male and female) of myops with an average age of 48.5 ± 5 years. The procedure used topical anesthesia and diffractive presbyopic phakic lens IPCL (EyeolUK Ltd) with +3D near addition was implanted through 1.8 to 2,2 mm incision. Patients were monitored for 5 years, assessing distance and near visual acuity, intraocular pressure (IOP), and endothelial cell count (ECC) and subjective satisfaction.

All procedures were uneventful, with the exception of one iridectomy bleeding when an older design without central opening was used. The spherical equivalent refraction decreased from -6.91 ± 2.66 D to -0.52 ± 0.63 D after 5 years. Thus UDVA improved from 1.3 ± 0.25 logMAR to 0.12 ± 0.15 logMAR. CDVA remained stable throughout the follow-up. At least 68% of the eyes achieved UNVA of J1 at 5 years, 88% of eyes were reading at least J4 and all eyes were reading J11. ECC and IOP with the exception of two temporary pressure spikes after the surgery remained stable.

Our 5-year data show that presbyopic IPCL implantation is an effective and safe method to correct both distance and near refraction of myopic presbyops. We've made the implantation process simpler over the years, eliminating the need for the use of OVD and intraocular pharmacological miosis. This approach is quicker, requires less surgical manipulation and reduces the risks of post-operative pressure spikes. We do not implant presbyopic phakic lenses in hyperops where we prefer refractive lens exchange with trifocal IOL implantation.