Five Years Follow-Up of Acrysof Cachet® Angle-Supported Phakic Intraocular Lens Implantation for Myopia Correction

Abstract

Purpose. The Acrysof Cachet® angle-supported phakic intraocular lens (pIOL) (Alcon Laboratories, Inc., Fort Worth, TX) is designed to correct high refractive errors in human eyes. The aim of this study was to evaluate the outcome of AcrySof Cachet® angle-supported pIOL implantation with particular regard to efficacy and safety of the implant over a 60-month follow-up period. Design. Retrospective consecutive clinical case study. Methods. Prior to pIOL implantation, patients had a complete ophthalmologic examination including objective and subjective refraction, uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA), endothelial cells density (ECD), slit lamp photography, optical coherence tomography (OCT), Scheimpflug digital videokeratoscopy, optical biometry, slit lamp examination, intraocular pressure (IOP) measurement, and pupillometry. Postoperatively, patients received yearly a complete eye examination. Results. Thirty-one eyes of 16 patients were included in this study. The mean age was 36.2 ± 8.1 years. UCVA (logMAR) improved from 1.33 ± 0.20 before surgery to 0.08 ± 0.14 one year after surgery and was 0.20 ± 0.20 five years after surgery. CDVA (logMAR) improved from 0.10 ± 0.10 before surgery to 0.05 ± 0.13 one year after surgery and was 0.04 ± 0.14 five years postoperatively. The mean percentage of endothelial cells loss (ECL) was 11.51% over the first year and 15.95% five years after surgery. There were no intraoperative complications in any of the eyes. Conclusions. Our results up to five years after implantation of the AcrySof Cachet® angle-supported pIOL demonstrated very good outcomes in all above shown measurements, including CDVA, UCVA, and ECD. However, since major endothelial cell loss may occur in some patients with this type of pIOL, regular follow-up visits are required.

Phakic intraocular lenses: an update and review for the treatment of myopia and myopic astigmatism in the United States

“…There are currently three pIOLs approved by the Food and Drug Administration (FDA) in the USA (Tables 1 and 2) [5,6,7 && ]. The only forms are of the iris and posterior chamber-supported variety, as Alcon (Fort Worth, TX, USA) discontinued the last AC-pIOL called the Cachet lens in 2014, after 2.7% of the 1323 eyes had lenses explanted due to endothelial cell loss (ECL) during clinical trials [8]. The US approved the Verisyse lens in 2004, an implant synonymous with the Artisan type that is widely used globally and available in two models, 204 and 206.…”

“…Most patients who receive pIOLs achieve equal or better UDVA compared to their preop CDVA. Improved visual acuity postoperatively with pIOLs, especially in higher myopes, is achieved by increasing the image magnification and having the location of the ICL closer to the nodal point of the eye, as compared to spectacles or contact lenses [8]. Regarding the difference in performance between IF-pIOL and PC-pIOLs, both have similar CDVA results following implantation; however, PC-pIOLs such as the Visian ICL family have more desirable UDVA outcomes over the iris-fixated options (Figs.…”