Positional Stability of Haptics of Phakic IOL: 6-Month Follow-up
Narrative Responses:
Purpose
To evaluate the possibility of endothelial damage caused by improper position and unstability of the haptics of an angle-supported phakic intraocular lens (pIOL) during 6months after implantation in myopic eyes.
Methods
A Cachet pIOL (Alcon, Laboratories, Inc., Fort Worth, Tx) was implanted in 44 eyes of 22 patients with moderate to high myopia. The position and stability of the haptics of the pIOL was evaluated using gonioscopic photographs captured digitally at 1, 3, and 6 months postoperatively. At the same time, Indentation gonioscopy was performed to check the haptic movement during eyeball compression to imitate eyeball rubbing. The endothelial cell density (ECD) was assessed preoperatively and 1, 3 and 6 months postoperatively.
Results
Slight haptic movement in rotational direction was shown postoperatively. But, the position of haptics in aspect of anatomical structure of iridocorneal angle was not changed. All the haptics were placed on the peripheral iris. Their tip was touching ciliary body band only (153 haptics, 87%) and scleral spur (23 haptics, 13%). There was no encroachment on the trabecular meshwork and its anterior structure. Indentation with a Sussman mirror lens didn’t change the position of the haptics in every follow-up. The mean loss of ECD was 0.6 % (2821 ± 316 cell/mm2 at preop, 2652 ± 371 cell/mm2 at postop 6 mo).
Conclusion
The haptics of Cachet pIOL kept their distance from the Schwalbe’s line and maintained relatively stable position during the postop 6 months. Long-term follow-up is necessary to evaluate the effect on the angle structure by focal pressure of the haptics.