Introduction. The use of phakic intraocular lens (PIOL) for the correction of high ametropia is reflected in the works of both domestic and foreign ophthalmologists. In spite of this, there are very few publications which are devoted to the long-term outcomes of the use of domestically produced models of PIOL such as RSK-1(3) and RSK-3. Purpose. The main aim of this work is to assess the clinical and functional outcomes of the use of domestically produced models of PIOL such as RSK-1(3) and RSK-3. Material and methods. A retrospective analysis of the long-term results of PIOL implants performed at the Fyodorov Eye Microsurgery Federal State Institution was carried out from 1994 to 2001. The analysis involved 122 eyes of 84 patients with high myopia from who were implanted with posterior chamber negative PIOL with two haptic elements (RSK-3) and PIOL with three haptic elements (RSK-1(3). Results. Analysis of the dynamics of postoperative refractive data in compare with preoperative parameters showed us that in all cases there was a significant increase in uncorrected and corrected visual acuity. Long-term outcomes of implantation were found in 25 patients (43 eyes). The average duration of PIOL in the eye was 14.30±1.3 g (from 2 to 30 years). In all cases, the reducing cell density of the corneal epithelium did not exceed 4.0% in the early postoperative period. At the same time, the main complication in the distant postoperative period was the development of subcapsular cataracts. Conclusions. This method of ametropia correction can be recommended to young patients, who are not suitable for keratorefraction interventions. Key words: phakic intraocular lens, high myopia.
To date, the operation of choice in young patients with high myopia, is the implantation of posterior chamber phakic intraocular lenses (PIOL), provided that there are contraindications to keratorefractive interventions, However, in the late postoperative period, cataracts may occur, which requires the development of surgical tactics for lens explantation with simultaneous phacoemulsification of cataract (FEC) implementation.The purpose is to develop and analyze a method for removing a PIOL through a 2 mm corneal incision in subcapsular cataract cases.Material and methods. Posterior chamber domestic models of PIOL type RSK-1(3) and RSK-3 in 22 patients (37 eyes), implanted in the S.N. FEDOROV “EYE MICROSURGERY” clinic in 1994 – 2001 had to be removed due to the development of secondary cataracts. PIOL stayed in the eye 2 to 26 years (averagely 14.30 ± 1.30 yrs). In all cases, the P IOL was removed followed by FEC with implantation of a posterior chamber IOL. The optical power of the IOL was calculated mainly in such a way that the residual myopic refraction was 2.0–3.0 D.Results. The intraoperative condition of the anterior chamber was stable, the volume of irrigation fluid consumed was within 90–120 ml. No complications were detected in the early and late postoperative periods. The results of dynamic ophthalmological follow up of patients showed that visual acuity without correction and with correction after surgery averaged 0.2 ± 0.1 and 0.60 ± 0.15, respectively.Conclusion. The proposed method of explantation of domestic lenses of S.N. FEDOROV NMRC MNTK “EYE MICROSURGERY” shows that it enables a safe, simple removal of PIOL in the event of secondary subcapsular cataract, which allows achieving high clinical and functional results without overspending the irrigation solution.
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