Surgical Outcome and Safety Profile of Posterior Chamber Phakic and Iris-Claw-Fixated IOLs in Moderate to High Myopic Astigmatism
Narrative Responses:
Purpose
To compare the surgical outcome and safety profile of implantable posterior chamber phakic lenses (ICLs; Staar Surgical, CA) versus iris claw lenses (Artiflex, Ophtec, Netherlands) for the correction of moderate to high myopic astigmatism.
Methods
A retrospective study was performed on 1184 patients with moderate to high myopic astigmatism ranging from -6 to -19.5 diopters (D) who had undergone phakic IOL implantation in at least one eye with a follow up period of at least one year. Uncorrected Distance vision (UCVA), manifest refraction (MR), intraocular pressure (IOP), central endothelial density (CED), IOL vaulting (V) and adverse events were analyzed at 1, 2, 3, 6 and 12 months after surgery.
Results
The UCVA and improved significantly in both groups (P < .001). There was no statistically significant difference in postoperative UCVA (P = .64) between the two groups.IOP and MR were also comparable at all follow up periods. There was an insignificant but a higher trend of endothelial loss after iris claw lens implantation (P = 0.22) at 1 year. The iris claw lens group showed a higher rate of low grade inflammation at 1 month that required topical steroid use. The posterior chamber IOL group showed IOL exchange rate of 0.41 % (8 eyes of 1974) due to inadequate vaulting.
Conclusion
Both posterior chamber and iris claw PIOLs have comparable satisfactory visual outcomes and safety profiles after surgery. However, each group shows certain post- operative phenomena that seem to be characteristic of the lens design. Thus, careful clinical follow up is indicated.