Retinal Detachment in Myopic Eyes After Phakic Intraocular Lens Implantation

Abstract

PURPOSE: To analyze the risk of retinal detachment in highly myopic patients who underwent implantation of phakic intraocular lenses (PIOLs). METHODS: In a retrospective, non-comparative, interventional case series, the occurrence of retinal detachment was analyzed in 522 consecutive highly myopic eyes (323 patients) that underwent PIOL implantation. Treatment and results were reviewed. Parameters evaluated were best corrected visual acuity before and after retinal detachment surgery and time between refractive surgery and retinal detachment. RESULTS: Fifteen (2.87%) eyes presented with retinal detachment after PIOL implantation, with a mean time between surgery and detachment of 24.4 ±24.4 months (range: 1 to 92 months). The risk of retinal detachment in patients with high myopia corrected by PIOL implantation was 0.57% at 3 months, 1.64% at 12 months, 2.73% at 36 months, and 4.06% at 92 to 145 months (Kaplan-Meier analysis). A comparative study between the group of patients with retinal detachment and the remaining patients without retinal detachment was performed. Differences were found in axial length (30.65±1.97 vs 29.51±2.02; P=. 028, one factor-analysis of variance test). CONCLUSIONS: The risk of retinal detachment in eyes implanted with phakic lenses for the correction of high myopia is higher in eyes with axial length >30.24 mm. [J Refract Surg. 2006;22:247-252.]

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

“…72 Phakic intraocular lenses have not been associated with increased risk of retinal detachment compared with other intraocular interventions in highly myopic patients. 71,73,74 For management and treatment for PVD and RRD, the following outcomes are important: A patient history should include the following elements: ◆ Careful examination of the peripheral fundus using scleral depression 82 (see Table 3)…”

Optical Coherence Tomography of the Anterior Segment in Eyes with Phakic Refractive Lenses

“…The patient population undergoing refractive surgery is largely myopic and as such is particularly vulnerable to posterior segment pathology. PIOL implantation in myopic eyes is associated with the risk of retinal detachment that ranges from 0.8% to 4.8 % (Ruiz-Moreno et al 2006). A dilated fundus examination is an integral part of optimum clinical care in patients who undergo refractive surgery, and shared preoperative assessment by a retinal specialist is advisable in those with a predisposing retinal pathology (Brady et al 2007).…”

Long-term Results of Phakic Refractive Lens Implantation in Eyes With High Myopia

“…Phakic intraocular lens implantation carries risks such as cataract formation, infl ammation and infection, decentration, and retinal detachment especially when treating high myopia. 4 Currently, three types of refractive lenses are used for correcting refractive errors: anterior chamber, iris-fi xated, and posterior chamber. Two types of posterior chamber phakic refractive lenses are available for the correction of high myopia and hyperopia-Implantable Collamer Lens (Visian ICL; STAAR Surgical, Monrovia, California) and Phakic Refractive Lens (PRL; Carl Zeiss Meditec, Jena, Germany).…”