title: Transient myopic shift after phakic intraocular lens implantation.
abstract: Three patients presented with spontaneous myopic shift 6 weeks to 6 months after implantation of the Artiflex phakic intraocular lens (pIOL). The corrected distance visual acuity (CDVA) was maintained in all cases. Cyclopentolate drops successfully reverted the myopic shift in all cases; however, 2 cases required surgical reenclavation of the pIOL haptics to achieve long-term refractive stability. At the last follow-up, all patients had returned to emmetropia, with uncorrected distance visual acuities of 20/20. A slight decrease in objective optical quality was observed. No eye lost a line of CDVA. In 1 eye, optical coherence tomography scans showed slight posterior positioning of the pIOL. These cases show that spontaneous myopic shift is a potential complication of iris-claw pIOL implantation. That cyclopentolate drops and/or reenclavation of the haptics were effective in reverting the situation suggests a mechanical mechanism related to iris and ciliary body dynamics.
  
  
  BACKGROUND
  Dr. Güell is a consultant to Ophtec. No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Cornea and Refractive Surgery Unit, Ophthalmology Department, Instituto de Microcirugia Ocular, Universitat Autonoma de Barcelona, Barcelona, Spain. guell@imo.es
authors.forename: Jose L
authors.initials: JL
authors.lastname: Güell
authors.forename: Merce
authors.initials: M
authors.lastname: Morral
authors.forename: Oscar
authors.initials: O
authors.lastname: Gris
authors.forename: Daniel
authors.initials: D
authors.lastname: Elies
authors.forename: Felicidad
authors.initials: F
authors.lastname: Manero
mesh_terms: D000328:Adult; D003519:Cyclopentolate / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D009184:Mydriatics / Q000008:administration & dosage; D009216:Myopia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D054120:Phakic Intraocular Lenses / Q000009:adverse effects*; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D009184:Mydriatics; D003519:Cyclopentolate