Correction of high myopia with different phakic anterior chamber intraocular lenses: ICARE angle-supported lens and Verisyse iris-claw lens.

PURPOSE: To evaluate the efficacy, predictability and safety of implanting two models of anterior chamber IOLs for high myopia. Comparison of the refractive results between two groups of patients implanted with different IOLs. MATERIALS AND METHODS: Forty eyes were implanted with phakic IOLs. The ICARE myopia lens was implanted in 20 eyes of 12 patients with preoperative myopia that ranged from -21.875 to -10.0. The mean patients' age was 30 years. The Verisyse IOL was implanted in 20 eyes of 12 patients with spherical equivalent of the refractive error from -21.625 to -10.375D, and the mean patients' age was 32.25 years. The dioptric power of the intraocular lens was calculated by considering refraction, keratometry, and anterior chamber depth. The follow-up period was 12 months. RESULTS: Twelve months after surgery, the mean refractive error (SE) was -0.19D (100% of eyes were within +/-1.0D of the target refraction) in the ICARE group, and -0.86D (95% of eyes were within +/-1.0D of the target refraction) in the Verisyse group. The postoperative refraction remained stable during the entire follow-up period. The mean uncorrected visual acuity was 0.7 in the ICARE group, and 0.69 in the Verisyse group 1 year postoperatively. There was no loss in visual acuity 1 year after surgery in the ICARE implanted eyes, one patient in the Verisyse group lost 1 line of BCVA as compared to the preoperative state. Mean endothelial cell density loss was 6.12% and 6.79% in the ICARE and Verisyse groups, respectively. There were no statistically significant differences regarding the analyzed outcome parameters between the two study groups. CONCLUSION: The implantation of both anterior chamber phakic intraocular lenses to correct high myopia resulted in a stable and predictable refractive outcome. Efficacy and safety of surgery for both implanted lens models are very high.

[Retrospective evaluation of eyes with high progressive myopia in children and youth ten years after Snyder and Thompson's scleroplasty]. / Retrospektywna ocena oczu z krótkowzrocznoscia postepujaca u dzieci i mlodziezy poddanych przed 10 laty zabiegowi skleroplastyki wg Snydera i Thompsona.

PURPOSE: Of the study was, to assess the safety and efficiency of scleral reinforcement after Snyder and Thompson surgery. MATERIAL AND METHODS: The scleroplasty was performed on 129 eyes of 75 children with progressive myopia from 6 to 10 years of age. The control study group included 40 eyes of 25 children with similar age, mean eyeball axial length and refraction. In the control study group scleroplasty was not performed. The main indication criteria for surgery included: severe myopia more than -6.0 D, and the increase in refraction error more than -1.0 D per year. We evaluated the eyeball axial length in all subjects, before time of surgery and ten years after surgery, using Ultrasound Alcon Imaging System. The visual acuity, tonometry, visual field were evaluated as well. RESULTS: In the study group the mean eyeball axial length measured before surgery was 25.95 mm +/- 0.62 mm. Ten years after surgery the length of the eyeball was 26.97 mm +/- 0.64 mm. The average increase was 1.03 mm +/- 0.29 mm. In the control group, at the time when study group children were operated, the mean eyeball axial length was 25.91 mm +/- 0.48 mm, and ten years later it was 28.06 mm +/- 0.59 mm. The average increase in the eyeball length was 2.13 mm +/- 0.3 mm. There was statistically significant difference between the eyeball axial length progression in the study group and the control group, where surgery was not performed. In the study group no serious complications after surgery were reported. CONCLUSIONS: Scleral reinforcement is an effective and safe surgery, that can stabilize the progression of severe myopia in children.

[Phakic IOL]. / Soczewki fakijne.

Refractive errors can be corrected by three different means, as follows: optical devices, corneal refractive surgery and intraocular procedures. Each intraocular procedure has its advantages and disadvantages. In this paper the authors present the nowdays state of refractive phakic IOL's.

[Correction of high myopia with anterior chamber angle-supported phakic intraocular lenses--own results]. / Chirurgiczna korekcja wad refrakcji metoda wszczepów wewnatrzgalkowych--wyniki wlasne.

PURPOSE: To evaluate the early results: predictability, efficacy and safety of implanting new model of anterior chamber IOL for high myopia. MATERIAL AND METHODS: ICARE myopia lens (Corneal) was implanted in 20 eyes of 12 patients with preoperative myopia that ranged from -10 D to 23.5 D. Mean patient age was 32.3 years. The follow-up period was 6 months. The desired outcome was emmetropia. RESULTS: Eighteen eyes (85%) had a postoperative refraction at the last follow-up examination in a range +/- 1.0 D of emmetropia. The postoperative refraction remained stable during the entire follow-up period. Mean visual acuity before surgery, corrected with spectacle improved from 0.5 to 0.68 postoperatively without glasses in 3 months time. There was no loss in visual acuity after operation. We didn't encounter major complications. Mean endothelial cell density reduction was 3.2% in our 3 months study. CONCLUSIONS: Implantation of ICARE myopia lens to correct high myopia resulted in a stable and predictable refractive outcome. Further investigation is necessary to evaluate long-term stability and safety of this procedure.