Iris Claw Phakic Intraocular Lens for High Myopia

Abstract

BACKGROUND: The implantation of a WorstFechner iris claw intraocular lens (IOL) is one of the surgical procedures used for the correction of high myopia. This technique reduces myopia with stähle refractive results; however, its potential long-term risks have not been evaluated. We report results in 94 eyes with a minimum follow -up of 3 years. METHODS: We studied 94 eyes of 62 patients with myopia 5= -7.00 diopters (D) who underwent Worst-Fechner IOL implantation. Lens decentration, permeability of the blood-aqueous barrier by iris angiography, and changes in corneal endothelial density were analyzed. RESULTS: Mean follow-up time was 48.9 months (range 36 to 72 mo). Three years after surgery, 58 eyes (61%) had an uncorrected visual acuity s* 20/40, and 77 eyes (82%) gained two or more lines of spectacle-corrected visual acuity with respect to the preoperative value; 75 eyes (79%) were within ±1.00 D of emmetropia and 46 eyes (48%) were within ±0.50 D of emmetropia. The mean endothelial cell loss was 17.9% at 5 years after surgery, while the percentage of hexagonality and the coefficient of cell variation tended toward preoperative levels. No vision threatening complications were seen. CONCLUSIONS: The implantation of a WorstFechner iris claw phakic IOL reduced high myopia with a stable refractive outcome. Endothelial cell damage was within acceptable limits. The absence of major complications makes this procedure an acceptable method for correcting high myopia. [J Refract Surg 1997;13:545-555]

Phakic intraocular contact lenses–perversion of a profession?

“…449±453, 1999 # 1999 Elsevier Science Ltd. All rights reserved All rights reserved. Printed in Great Britain 0275-5408/99/$20.00 + 0.00 PII: S0275-5408(99)00060-5 of 20% in 1 year (Mimouni et al, 1991), 13.2% in 4 years (Menezo et al, 1998), and 17.9% in 5 years (Menezo et al, 1997). This level of endothelial cell death is considerably higher than the one attributed to normal aging, which has been reported to be 0.56% per year (Murphy et al, 1984).…”

“…A survey of existing literature also reveals a list of other signi®cant complications. As in cataract surgery, the limbal incision used to enter the anterior chamber is the cause of endothelial cell loss, which may be compounded by an anterior chamber positioning of the IOCL (Mimouni et al, 1991;Menezo et al, 1997;Baiko et al, 1998;Menezo, Cisneros and Rodriguez-Salvador, 1998). This cell loss may be as little as 3.8% in the ®rst 6 months (Baiko et al, 1998), while other studies have reported long term losses Ophthal.…”

Surgical management of aphakia

“…The high incidence of complications in anterior chamber IOLs (AC IOLs) initially were due to their earlier closedloop design. 16,17 With the advent of open-loop design, complication rates decreased significantly. Auffarth et al reported that of 4104 AC IOLs that were explanted because of complications, 50% were closed-loop designs, 26% miscellaneous old designs, and 22% open-loop designs.…”