Iris-fixated phakic intraocular lens implantation for correction of high myopia in microspherophakia

Abstract

We report the refractive correction of high myopia in a 23-year-old patient with idiopathic microspherophakia using iris-fixated phakic intraocular lenses (pIOLs) (Verisyse/Artisan). Four years after bilateral implantation, the uncorrected distance visual acuity was 20/25 with a correction of 20/20(-1) in both eyes. No intraoperative or postoperative complications occurred. Iris-fixated pIOLs are not recommended for every patient with microspherophakia. However, this procedure may be an option in microspherophakic patients with appropriate anterior chamber depth and no history of lens dislocation who are likely to comply with annual eye examinations. Follow-up should include monitoring the endothelial cell count and biomicroscopy for adequate space between the pIOL, the natural crystalline lens, and the corneal endothelium. Scheimpflug photography can be a valuable tool in such cases.

Incidence rate and occurrence of visually significant cataract formation and corneal decompensation after implantation of Verisyse/Artisan phakic intraocular lens

“…At the time of insertion of the pIOL, the patient’s ACD was 2.87 mm, which met the manufacturer’s recommendation of a minimum depth of 2.6 mm at the time of the surgery in 2006 15. Smaller ACD is correlated with increased endothelial cell loss,16 and the current recommendation for minimum ACD is 3.2 mm.…”

Three-year follow-up of secondary anterior iris fixation of an aphakic intraocular lens to correct aphakia

“…The Artisan IOL (Ophtec BV), a poly(methyl methacrylate) (PMMA) iris-fixated IOL, has a better design than previous generations and has been successfully used to correct aphakia 5,[9][10][11][12][13] and high myopia 1,14,15 in many countries.…”

Scleral- fixated intraocular lens implantation in microspherophakia

“…[5121314151617181920] In our experience, implantation of SFIOL in patients with microspherophakia managed both subluxation and glaucoma and gave excellent optical results. The procedure is technically challenging, with a learning curve to achieve a good visual outcome.…”

“…Some investigators[1213] have tried to correct high myopia in microspherophakia by using iris-fixated phakic lenses. Management of microspherophakia with lenticular subluxation is a great surgical challenge, since the combined effects of a small capsular bag, an average lenticular equatorial diameter of 6.75 to 7.5 mm and zonular instability predispose to intraoperative and postoperative complications.…”