title: [Three kinds of phakic intraocular lens for correction of high myopia].
abstract: OBJECTIVE
  To evaluate the efficacy, safety and stability of three kinds of phakic intraocular lens implantation for the correction of high myopia.
  
  
  METHODS
  This study included 208 eyes of 110 patients with a mean age of 31 years (21 - 53) from December 2003 to December 2009. Angle-supported lens (Phakic 6H, OII) were inserted into 113 eyes, iris-fixated lens (Artisan, OPHTEC) were inserted into 53 eyes and implantable contact lens (ICL) (V4, STAAR) were inserted into 41eyes. The average follow-up time of the three groups were 54.0 months (3 - 72 months), 15.7 months (3 - 24 months) and 7.2 months (3 - 15 months) respectively.
  
  
  RESULTS
  At 3 months and 12 months, the efficacy indexes of the three groups were all above 1.00. Only the angle-supported group was followed up to 72 months postoperatively when the efficacy index dropped to 0.85, but still UCVA was 1.0 (20/20) or better in 16% eyes and 0.5 (20/40) or better in 85% eyes. The safety indexes of the three groups were always above 1.00 during the follow up. In the angle-supported group, 46% eyes were within ± 0.50 D of the desired refraction and 68% eyes were within ± 1.00 D at 5 years postoperatively. In the iris-fixated group, 78% eyes were within ± 0.50 D of the desired refraction and 100% eyes were within ± 1.00 D at 1 years postoperatively. In the ICL group, 95% eyes were within ± 0.50 D of the desired refraction and 100% eyes were within ± 1.00 D at 3 months postoperatively. No statistically significant differences were found between preoperative and 3-month postoperative endothelial cell density in the ICL group. Also, there was no statistically significant reduction in endothelial cell density at 1 years in the iris-fixated group. However, when preoperative and 5-year postoperative measurements were compared in the angle-supported group, the total decrease in cell density is statistically significant (t = 9.769, P = 0.000). 16 eyes developed high IOP within 1 month postoperatively which resolved after intervention. In the three groups (angle-supported, iris-fixated and ICL), the most common complications were pupil ovalization, iris atrophy plus pigment dispersion and lens opacification respectively.
  
  
  CONCLUSIONS
  Although phakic IOL implantation is predictable and safe for treatment of high myopia in short-term, the long-term complications should be concerned and treated well.
authors.affiliation: Department of Ophthalmology, Shanghai Jiaotong University, Shanghai 200025, China.
authors.forename: Zhi-hua
authors.initials: ZH
authors.lastname: Zhang
authors.forename: Jing-cai
authors.initials: JC
authors.lastname: Lian
authors.forename: Hua-ping
authors.initials: HP
authors.lastname: Liao
authors.forename: Shi-sheng
authors.initials: SS
authors.lastname: Zhang
mesh_terms: D000328:Adult; D004869:Equipment Safety; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D054120:Phakic Intraocular Lenses / Q000145:classification; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult