Phakic Intraocular Lenses As Non-Refractive Surgery

Phakic lens implants have good tracking records on safety and efficacy in correcting myopia and astigmatism. We want to study visual and refractive outcomes as well as patients reported outcomes of sulcus-based phakic Intraocular implants (IOL) in correcting refractive errors in patients with ocular morbidity.

Corneo-Plastic Unit, Queen Victoria Hospital, East Grinstead, UK

Retrospective review of sulcus-based phakic Intraocular implants (IOL) in the management of refractive errors for indications outside conventional refractive surgery such as keratoconus, post keratoplasty, paediatric ametropia, and residual refraction in pseudophakia. Implantable collamer lens was used in all patients. Minimum follow up of three months. Outcome measures were UDVA, CDVA, subjective refraction, spherical equivalent, refractive astigmatism, and complications.

70 eyes (48 patients) underwent sulcus-based phakic IOL with follow-up 3–60 months. There was significant increase in number of eyes with an uncorrected distance visual acuity (UDVA) of 20/40 or better from 0% to 71%. More than 85.7% of eyes achieved post-operative UDVA equal to or better than the pre-operative corrected distance visual acuity (CDVA). Percentage of eyes with CDVA of ≥20/40 increased from 31% to 100%. Mean final spherical equivalent improved from -4.07 to -0.17 (p ⩽ 0.001). Mean refractive astigmatism magnitude improved from 4.76D to 1.23D (p=0.002). 40% of the eyes had ≤1.0D of refractive astigmatism post-operatively. No corneal decompensation, cataract, or glaucoma developed in any patient throughout the follow up period.

Sulcus-based phakic IOL implants have high profile of safety and efficacy in correcting refractive errors in patients with keratoconus and after keratoplasty.