ABSTRACT
This study aimed to evaluate the clinical and refractive outcome of angle supported phakic intraocular lenses [PIOLs] in the correction of high myopia. Thirty-one eyes of 17 highly myopic patients with a mean age of 27.9 [ +/- 5.1 SD] years were implanted with PIOLs [phakic 6 IOL, OII]. Mean preoperative spherical equivalent [SE] was -16.9 diopters [ +/- 3.84 SD]. Preoperative evaluation included subjective refraction, slit lamp biomicroscopy, tonometry and dilated fundus examination for all patients. PIOL power calculation was based on subjective refraction, AC depth and keratometry using the nomogram supplied by the PIOL manufacturer. Mean follow up period was 11.8 months [range 6-18 months]. The results revealed that mean preoperative best-corrected visual acuity [BCVA] was 0.8 [ +/- 13 SD]. Mean postoperative SE was -0.86 [ +/- 0.75 SD]. Mean postoperative uncorrected visual acuity [UCVA] was 0.67 [ +/- 0.27]. Mean postoperative BCVA was 0.97 [ +/- 0.04 SD]. Specular microscopy was performed on 15 patients preoperatively and at 12 months postoperative. It showed a mean reduction of endothelial cell density of 5.6% one year after surgery. Postoperative anterior uveitis occurred in 2 patients [6.4%]. Pupil ovalization occurred in 2 patients [6.4%] at 12 months postoperative. Steroid induced ocular hypertension occurred in 3 patients [9.6%] at one week postoperative and resolved on adding a topical beta blocker until topical steroids were tapered then discontinued. The study concluded that PIOL implantation is a relatively simple, potentially reversible and a precise procedure for correction of high myopia. It has a predictable and stable refractive outcome. Longer follow up, however, is necessary to evaluate long-term complications such as endothelial cell loss, cataract formation, iris retraction and retinal changes