Clinical evaluation of visual quality following implantation of posterior chamber phakic intraocular corrective lens for high myopia / 中华实验眼科杂志

ABSTRACT

Background Implantation of phakic posterior chamber intraocular corrective lens(ICL)is a new choice for correction of high myopia.Different from laser assisted in situ keratomileusis,implantation of phakic posterior chamber ICL will allow the good imaging quality because it remaines the matched relationship between cornea and lens.But its visual quality after operation is concerned by patient and ophthalmologists.ObjectiveThis study was to observe the effectiveness of implantation of posterior chamber phakic ICL on visual quality in patients with high myopia.Methods Eighty-four high myopia eyes of 42 patients accepted implantation of posterior chamber phakic ICL and follow-up of 6-month duration.The visual acuity,refractive status,wavefront,contrast sensitivity and accommodation were examined and compared before and after surgery.This clinical study complied with Declaration of Helsinki.The written informed consent was obtained from each patient before operation.Results A prospective observational trial design was used.The uncorrected visual acuity and best corrected visual acuity after operation were better than preoperative ones in all of the patients.The eye numbers of ＞ 0.3 were increased after operation in comparison with before operation with a stable result among 1 day,1 month and 6 months after surgery (x2 =10.70,P＞0.05).Spherical equivalent refraction was(-15.38 ± 1.03)D before surgery and(+0.55 ±0.06)at 1 day,(-1.22±0.09)D at 1 month and(-0.68 ± 0.06)D after 6 months,showing a significant difference among them(F=16 559.90,P＜0.05).Total aberrations and higher-order aberrations were 11.00±0.25 and 0.43 ±0.05 before surgery,the wavefront aberrations were 2.21 ± 0.56 and 0.47±0.04 at 6 months after surgery with significant difference(t =1.65,P =0.10).Each spatial frequency contrast sensitivity and glare sensitivity on photopic and seotopie conditions in postoperation were higher compared with the preoperative(P＜0.05).The accommodation in 1 month and 6 months after surgery was greater than that of preoperative in the patients ＜-16 D(preoperation2.75 ± 1.20 ; postoperation 1 month5.75 ± 1.44,postoperation 6 months6.00 ± 1.52)(P＜ 0.05),however,in the ＞-16 D group,no considerably change in accommodation was seen after surgery(F=1597.70,P＜0.05).No significant difference was found in accommodation between before and after surgery in ＞-16 D group(F=2.67,P＞0.05).Conclusions Visual quality of high myopia is obviously improved after implantation of posterior chamber phakic ICL,but its long-term outcome is need to further study.