Long-Term Follow-up of Supplementary IOL Implantation for Refractive Enhancement in Pseudophakic Patients
Purpose
To evaluate long-term refractive and visual outcomes following implantation of a supplementary intraocular lens in the ciliary sulcus to correct pseudophakic ametropia.
Methods
This prospective, non-randomized, study included 45 eyes that received a secondary intraocular lens (Sulcoflex 653L) to correct residual refractive error post cataract surgery. All IOLs were implanted with an injector through a 2.75 mm clear cornea incision in the ciliary sulcus. Postoperative examinations were performed after 1, 6 months and yearly. The study protocol included the assessment of visual acuity (UCVA, BCVA), specular microscopy and scheimpflug photography.
Results
Surgeries were performed without any complication in all cases; The mean follow up was 29 months (range 12 to 84 months). Emmetropia (±0.50 D) or target refraction were achieved in all cases with stable refractions. 5 years after the surgery, 1 eye showed refraction change due to macular edema and choroidal neovascularization associated with age-related macular degeneration. Flare values were lower than the values measured after standard cataract procedures. We did not observe secondary IOL decentration. IOP was within the normal range at all visits. No iris chafing was documented, and in all cases, a good distance was observed between the iris and the Sulcoflex Pseudophakic Supplementary IOL. 3 eyes showed slight pupil ovalisation. Similarly, a good distance was also observed between the supplementary IOL and the primary implant.
Conclusion
The Supplementary IOL was well tolerated in all study eyes. Secondary implantation of the Sulcoflex IOL in the ciliary sulcus was a safe and predictable option for patients with pseudophakic refractive errors.