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    Phakic anterior chamber lenses in very high myopia: an 18-month follow up
    (Wiley-Blackwell, 2012) Akcay, Levent; Eser, Ilker; Kaplan, Aysin T.; Taskiran-Comez, Arzu; Dogan, Omer K.
    Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Design: A prospective interventional case series at the Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey. Participants: Sixty-two eyes of 31 patients received iris-claw lens (group 1) (Artiflex AC 401, Ophtec), and 43 eyes of 22 patients received angle-supported lens (group 2) (I-Care, Corneal). Methods: The mean preoperative spherical equivalents for group 1 and group 2 were -12.13 D and -18.95 D, respectively. Endothelial cell density was measured at day 1 and at 1, 3, 6, 12 and 18 months for follow ups. Main Outcome Measures: Percentage change in endothelial cell density and improvement in visual acuity. Results: At the 18-months follow up, uncorrected visual acuity improved to logMAR 0.37 +/- 0.23 from 1.60 +/- 0.10 in group 1, and logMAR 0.47 +/- 0.14 from 0.70 +/- 0.20 in group 2; best spectacle corrected visual acuity improved to logMAR 0.23 +/- 0.22 from logMAR 0.36 +/- 0.14) in group 1, and logMAR 0.29 +/- 0.18 from logMAR 0.50 +/- 0.20) in group 2 (P < 0.001, in both groups). Mean decreased endothelial cell density was 241 cells/mm(2) (8.61%) and 223 cells/mm(2) (8.42%) at 18 months follow up in group 1 and 2, respectively (P = 0.17) but significant in comparison to preoperative values for both groups (P < 0.001). Conclusions: Although both iris-claw and angle-supported lenses offer good refractive outcomes significant endothelial cell density was observed at 18 months follow up.