Clinical Results of Posterior Chamber Phakic Intraocular Lens Implantation in Eyes With Low Anterior Chamber Depth

초록

PURPOSE: To investigate visual outcomes of Visian implantable Col lamer lens (ICL) implantation in eyes with a shallow anterior chamber depth (ACD). DESIGN: Retrospective, noncomparative, interventional case series. METHODS: Medical charts of the patients with a low ACD of 2.8 mm or less who underwent implantable Collamer lens implantation were reviewed. To evaluate efficacy and safety, preoperative and postoperative uncorrected visual acuity, manifest refractive spherical equivalent (MRSE), endothelial cell count, intraocular pressure, angle opening distance at 500 mu m from the scleral spur, trabecular-iris angle, and postoperative central vault were analyzed. RESULTS: The mean follow-up period for 18 eyes of 10 patients was 24.67 +/- 15.09 months (range, 10 to 51 months). The preoperative ACD was 2.71 +/- 0.08 mm (range, 2.42 to 2.79 mm). There was no postoperative endothelial cell count reduction to less than 2000 cells/mm(2) or intraocular pressure elevation to more than 21 mm Hg. The differences between preoperative and postoperative angle opening distance at 500 mu m from the scleral spur and trabecular-iris angle were statistically significant (P = .000, both). The mean postoperative central vault was 331.83 +/- 181.28 mu m (range, 174 to 811 mu m), which was significantly less than expected (P = .000). Anterior subcapsular cataract was observed in 2 eyes (11.1%). CONCLUSIONS: Implantable Col lamer lens implantation in shallow ACD eyes exhibited good visual outcomes. Severe complications did not develop over relatively long periods. Two cases of anterior subcapsular cataract developed in older aged patients, suggesting the need for thorough preoperative warning about the risk of cataract. In addition, a postoperative vault less than expected should be taken into account when determining implantable Col lamer lens size in lower ACD eyes. (C) 2014 by Elsevier Inc. All rights reserved.

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