Phakic intraocular lens implantation versus clear lens extraction in highly myopic eyes of 30- to 50-year-old patients.
OBJECTIVE
To compare the outcome of treatment for myopia by phakic intraocular lens (IOL) implantation or by clear lens extraction (CLE).


METHODS
Service d'Ophtalmologie, Hopital Purpan, Toulouse, France.


METHODS
Thirty-nine patients from 32 to 49 years of age were studied. Forty-one eyes of 21 patients received a phakic IOL, and 36 eyes of 18 patients had phacoemulsification of the crystalline lens. The mean preoperative spherical equivalent (SE) was -13.6 diopters (D) +/- 3.0 (SD) in the phakic IOL group and -16.7 +/- 3.8 D in the CLE group.


RESULTS
Postoperatively, the mean SE was -1.06 +/- 0.78 D in the IOL group and -1.88 +/- 0.83 D in the CLE group. At 12 months, the best corrected visual acuity (BCVA) had improved in 78.0% of eyes in the IOL group and 83.3% in the CLE group; no eye lost 1 line of BCVA. In 3 eyes (7.31%) in the IOL group, opacification of the crystalline lens developed 34, 36, and 44 months after implantation. Visual recovery after phacoemulsification was excellent. No eye in this group lost 1 or more lines of BCVA between 1 and 4 years of the initial surgery. In the CLE group, a retinal detachment occurred in 2 eyes at 39 and 43 months. The final BCVA in these eyes was counting fingers and 20/200.


CONCLUSIONS
Implantation of a phakic IOL in a highly myopic eye of a patient between 30 and 50 years of age can be considered an adequate technique with a lower risk for loss of BCVA than CLE.
Arne
Jean L
JL
Service d'Ophtalmologie, Hôpital Purpan, Toulouse, France. arne.jl@chu-toulouse.fr
D000328:Adult; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007908:Lens, Crystalline / Q000502:physiology* / Q000601:surgery*; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D017060:Patient Satisfaction; D018918:Phacoemulsification / Q000379:methods; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology