title: Outcomes of ZB5M angle-supported anterior chamber phakic intraocular lenses at 12 years.
abstract: OBJECTIVE
  To evaluate the visual and refractive stability and the potential long-term risks associated with ZB5M phakic intraocular lens (PIOL) implantation.
  
  
  METHODS
  A retrospective, non-randomized, cumulative clinical study was performed over 12 years in a consecutive group of 225 eyes implanted with the ZB5M PIOL. The main analyzed variables were visual and refractive outcomes (best spectacle-corrected visual acuity [BSCVA], uncorrected visual acuity [UCVA], and spherical equivalent), endothelial cell density, and postoperative complications.
  
  
  RESULTS
  Mean preoperative spherical equivalent refraction was -17.23 +/- 7.69 diopters (D) and 12 years postoperatively it was -1.80 +/- 0.80 D. Mean BSCVA at 1- and 12-year follow-up was 0.38 +/- 0.19 and 0.57 +/- 0.18, respectively (Wilcoxon test, P < .001). At 12 years postoperatively, 3.5% of eyes lost > or = 2 lines of BSCVA. An initial 10.6% reduction in endothelial cell density was noted in the first year, followed by a mean annual rate of decrease of 1.78%. The cumulative incidence of pupil ovalization was 34.7% (78 eyes), and there was no statistical correlation with endothelial cell impairment. Bilateral hypertensive uveitis was diagnosed in 3 (1.33%) eyes.
  
  
  CONCLUSIONS
  The ZB5M PIOL offers good refractive outcomes and stability in the long-term; however, endothelial cell loss increases over 12 years, requiring annual endothelial cell counts.
authors.affiliation: Instituto Oftalmológico de Alicante, Vissum Department of Refractive Surgery and Division of Ophthalmology, Miguel Hernández University, Medical School, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Javaloy
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: Maria T
authors.initials: MT
authors.lastname: Iradier
authors.forename: Ayman M
authors.initials: AM
authors.lastname: Abdelrahman
authors.forename: Tomas
authors.initials: T
authors.lastname: Javaloy
authors.forename: Fernando
authors.initials: F
authors.lastname: Borrás
mesh_terms: D000328:Adult; D000867:Anterior Chamber / Q000473:pathology / Q000601:surgery*; D002452:Cell Count; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007908:Lens, Crystalline / Q000502:physiology*; D007910:Lenses, Intraocular; D008875:Middle Aged; D009216:Myopia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014792:Visual Acuity