Hydrophobic Acrylic, Phakic, Angle-Supported IOL for Moderate to High Myopia: 2-Year Results
Narrative Responses:
Purpose
To evaluate the efficacy, safety and stability of the angle-supported Acrysof Cachet phakic intraocular lens (pIOL) to correct moderate to high myopia, and compare endothelial cell (EC) loss to EC loss after iris-fixated Artisan and Artiflex pIOL implantation.
Methods
In this prospective study, 117 eyes were included who underwent Acrysof Cachet pIOL implantation for moderate tot high myopia ranging from -6.00 to -16.5 diopters (D). Preoperatively and 6 month, 1 and 2 years postoperatively, uncorrected and best-corrected visual acuity (UCVA; BCVA), spherical equivalent (SE), EC counts and adverse events were documented. Furthermore, we compared EC loss to EC loss after Artisan (n=369 eyes), Artiflex (n=237 eyes) and toric Artisan (n=102 eyes) implantation at 6 months, 1 year and 2 years postoperatively. All surgical procedures were performed by the same surgeon.
Results
Two years postoperatively, UCVA was ≥20/40 in 100% of eyes and ≥20/20 in 53.3%, BCVA was ≥20/32 in 100% of eyes and ≥20/20 in 93.3%. Mean postoperative SE was -0.29±0.40D, residual refractive error was within ±0.50D of intended refraction in 75% and within ±1.00D in 94%. No eyes lost ≥2 lines of BCVA. Safety-index was 1.05. One patient developed pupil ovalization, which resulted in explantation of the pIOL. EC loss was 3.74%, 5.07% and 7.36% at 6 months, 1 and 2 years postoperatively, respectively. Compared to EC losses with the Artisan and Artiflex pIOL, the Cachet pIOL showed a significantly larger loss (P<0.05). When excluding the surgical loss, there were no significant differences (P>0.05).
Conclusion
The Acrysof Cachet pIOL effectively corrects moderate to high myopia, with good predictability and stability. Concerning the safety, no eyes loss 2 or more lines of BCVA. However, acute surgical EC loss is larger with the Cachet pIOL when compared to the Artisan and Artiflex iris-fixated pIOL.