Aim. To assess preliminary clinical functional outcomes of phakic intraocular lens pIOL-3 implantation in high myopia.Patients and methods. pIOL-3 was implanted in 6 patients (10 eyes) aged 27‑63 ...with high myopia and no concomitant pathologies. Follow-up period varied from 1 to 12 months. IOL is made of hydrophilic material Contamac CI26 with water content of 26% and refraction index of 1.46. pIOL design (holes in the haptic portions) provides its matching to ciliary sulcus size (0.5 mmless than linear size of the sulcus). Preoperative and postoperative examination included visual acuity measurement, biomicroscopy, ophthalmoscopy, visual field test, tonometry, endothelial microscopy, and ultrasound biomicroscopy. Simplicity of surgical technique, adaptability of haptics, and postoperative course were evaluated.Results. Early postoperative period was uncomplicated. Uncorrected (UCVA) and best-corrected visual acuity (BCVA) improved in the first hours after the surgery. No visual acuity worsening (as compared with preoperative BCVA) was observed. Surgical procedure did not affected IOP even despite the absence of basal iridotomy. Maximum endothelial cell loss was less than 5%. No IOL forward «vaulting» was observed.Conclusions. pIOL implantation in high myopia patients is safe and provides maximum visual acuity in the first postoperative hours. Owing to its design this IOL can be implanted into ciliary sulcus (which size is0.5 mmless than IOL diameter) without forward «vaulting».
Sorokoletov et al evaluate a frequency of secondary cataract development in different periods of postoperative follow-up after cataract phacoemulsification depending on the degree of axial myopia and ...the implanted IOL design. A retrospective analysis of secondary cataract formation in the long-term follow-up after cataract phacoemulsification with foldable intraocular lens implantation was performed in 16575 eyes out of 8722 patients with emmetropia and axial myopia. The average age of patients was 74±7 years. and the follow-up period was 5 years. The eyes with associated pathology such as glaucoma, diabetic retinopathy etc. were excluded from the study. Depending on the design of implanted IOL all eyes were divided into 3 groups. The first group included 5527 eyes with the implanted B-lens IOL (Hanita, Israel). The second group included 5629 eyes with the implanted Idea IOL (XCELENS, Switzerland). The third group consisted of 541 9 eyes with the implanted Acrysof natural, SA6OAT IOL (Alcon, USA). In every case the degree of myopia was evaluated using axial length of an eye that was measured instrumentally. The incidence of secondary cataract formation was evaluated on quantity of YAG-laser posterior capsule dissection within the 5-year follow-up after phacoemulsification with IOL implantation. According to our results the incidence of PCO is directly dependent on the axial length of the eye, strongly increasing in eyes with high axial myopia. The design and material of implanted IOL played an important role in PCO formation too. The eyes with the Acrysof natural, SA6OAT IOL (Alcon, USA) had the lowest incidence of PCO in the long-term follow-up.
To evaluate results in clinical application of reverse-M IOL in eyes with high myopia and cataract. Reverse-M IOL was implanted in 30 eyes with high myopia and cataract. The initial myopia varied ...within the range from 16.0 to 22.5D. The average patients age was 65 years. and the average axial length of the eyes was 31 mm. There was determined a destruction of vitreous body from 2 to 3 degree as well as a total posterior vitreous detachment with a average height of 6.5 mm. Visual acuity (VA) was not more than 0.2 with maximal spectacle correction. Average IOP was l8 mmHg. The follow-up was 18 months. Reverse-M IOL had a stable correct central position in all eyes. Uncorrected VA (UCVA) and with a low myopic correction was from 0.01 to 0.6 depending on a manifestation of vitreous destruction and myopic changes in fundus. Refractive result was stable during the whole follow-up. The average endothelial cell loss was not more than 3%. According to UBM data reverse-M IOL was located in capsular bag with a tight contact with the posterior capsule in all eyes. 1. Reverse-M IOL could be implanted through a 2.2 mm incision. 2. Reverse-M IOL ensures a tight contact of optics with the posterior capsule of the removed lens. 3. Reverse-M IOL provides predictable stable refractive results within the long-term follow-up. PUBLICATION ABSTRACT
