Visual Improvement in High Myopic Amblyopic Adult Eyes following Phakic Anterior Chamber Intraocular Lens Implantation

Abstract

PurposeTo evaluate the efficacy and safety of angle-supported phakic anterior chamber intraocular lenses in amblyopic adult eyes with very high myopia.MethodsWe evaluated 12 eyes in nine patients with very high myopic amblyopia who received angle-supported phakic intraocular lenses (Phakic 6H®) and followed them for more than six months. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and complications were evaluated. A satisfaction score was rated by patients using a 5-point (1~5) numeric scale.ResultsThe mean age of patients was 37.3±9.4 years, ranging from 29 to 59 years old. The preoperative mean refraction (spherical equivalent, SE) was -20.10±5.41 diopters (D). The postoperative mean refraction (SE) was -1.75±0.76 D at six months. The postoperative BCVA improved an average 3.92±1.24 lines over preoperative values, and mean endothelial cell loss was 8.9% at six months. Development of cataracts, glaucoma, and pupil abnormalities were not demonstrated in any case during the study. The patients were all very satisfied, as the average satisfaction score was 4.3.ConclusionsThis study indicates that angle-supported phakic anterior chamber intraocular lens implantation may be an effective surgical alternative for the correction of amblyopic adult eyes with very high myopia. However, long-term evaluation is necessary to assess possible complications and long-term safety.

Pre‐operative visual evaluation for implantable collamer lenses in highly myopic eyes

“…Astle and colleagues found that 30.3 per cent of patients with refractive amblyopia after laser‐assisted subepithelial keratectomy (LASEK) had a five to six line improvement in VA. Similar results were also reported in phakic intraocular lens implantation . Some patients classified as refractive amblyopes may not have been corrected in appropriate ways to induce emmetropia .…”

“…The Visian implantable collamer lens (ICL) (STAAR Surgical Inc, Nidau, Switzerland), a posterior chamber phakic intraocular lens (PIOL) provides safe, effective, predictable and stable visual and refractive outcomes for high myopia . In addition, this surgical procedure largely improves the visual acuity (VA) of highly myopic eyes . Although many patients with high myopia have poor pre‐operative spectacle visual acuity (SVA), a considerable number of patients unexpectedly achieve a normal or largely improved VA after surgery …”

Photorefractive keratectomy in treatment of refractive amblyopia in the adult population

“…To date, this has been documented only in children aged 3 to 7 years (in PEDIG studies 27 ). Kwon et al 28 made the assumption that numerous patients classified as amblyopia may not have been treated with the appropriate therapy to induce an appropriate emmetropic condition. Moreover, correction of astigmatism at the corneal plane instead of the spectacle plane may be a factor.…”

Metaanalysis of cataract development after phakic intraocular lens surgery

“…In Stage 2, 310 articles were retrieved, 229 of which satisfied Stage 3 criteria; 123 articles eventually satisfied Stage 4 standards and were included in the study. There were 24 articles on AC pIOLs, 4,11,12,15,23,26,27,53,[56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71] 5 of which described previously published cases. 15,53,62,63,69 There were 50 articles on IF pIOLs, 3,6,[8][9][10]28,30,31,33,[35][36][37][38][39] 14 of which covered formerly published cases.…”