Outcome after treatment of ametropia with implantable contact lenses.
OBJECTIVE
To evaluate long-term results after insertion of implantable contact lenses (ICLs) in phakic eyes.


METHODS
Prospective, noncomparative, interventional case series.


METHODS
Seventy-five phakic eyes (65 myopic, 10 hyperopic eyes) of 45 patients aged 21.7 to 60.6 years were included.


METHODS
STAAR Collamer Implantable Contact Lenses (STAAR Surgical Inc., Nidau, Switzerland) were implanted for correction of high myopia and hyperopia.


METHODS
Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were determined. Presence of lens opacification and the distance between the ICL and the crystalline lens were assessed by slit-lamp examination before surgery and at 1, 3, 6 months, and yearly after lens implantation.


RESULTS
Preoperative mean spherical equivalent was -16.23+/-5.29 diopters (D) for myopic eyes and +7.88 +/-1.46 D for hyperopic eyes. After ICL implantation, mean residual refractive error was -1.77+/-2.17 D in myopic patients and +0.44+/-0.69 D in hyperopic patients. Preoperative mean UCVA was Snellen 0.03+/-0.03 for myopic patients and Snellen 0.12+/-0.16 for hyperopic patients. Preoperative mean BCVA was Snellen 0.49+/-0.23 for myopic patients and Snellen 0.82+/-0.23 for hyperopic patients. After ICL implantation, mean UCVA up to the end of individual observation time was Snellen 0.36+/-0.36 for myopic patients and Snellen 0.58+/-0.28 for hyperopic patients. Mean BCVA was Snellen 0.73+/-0.26 for myopic and Snellen 0.80+/-0.24 for hyperopic patients. Mean preoperative IOP was 14.2+/-2.7 mmHg, and mean postoperative IOP was 13.46+/-2.1 mmHg over all follow-up investigations. The main complication was the development of subcapsular anterior opacifications of the crystalline lens in 25 eyes (33.3%), 2 of which showed direct contact to the ICL. Eleven eyes (14.7%) were stable in opacification and 14 eyes (18.7%) had progressive opacifications. The median time to opacification was 27.1 months. In 8 patients (10.7%), the subjective visual impairment mandated cataract surgery.


CONCLUSIONS
The most significant long-term complication after ICL implantation is the formation of opacifications of the crystalline lens with the risk of the necessity of subsequent cataract surgery (10.7%). Old age, female gender, and contralateral opacification are independent significant risk factors for early formation of opacifications in this patient group.
Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria. bridgit.lackner@akh-wien.ac.at
Birgit
B
Lackner
Stefan
S
Pieh
Gerald
G
Schmidinger
Georg
G
Hanselmayer
Irene
I
Dejaco-Ruhswurm
Martin A
MA
Funovics
Christian
C
Skorpik
D000328:Adult; D002386:Cataract / Q000209:etiology; D003261:Contact Lenses / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D007429:Intraocular Pressure; D007908:Lens, Crystalline / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000009:adverse effects; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity