title: Five-year functional outcomes and vault of -20 diopter myopic phakic intraocular lens implantation.
abstract: OBJECTIVE
  To evaluate refractive and visual outcomes and complications associated with phakic intraocular lens (pIOL) implantation to correct high myopia.
  
  
  METHODS
  Fernández-Vega Ophthalmological Institute, Oviedo, Spain.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction, vault, and adverse effects were evaluated after 5 years with Visian ICMV4 pIOL.
  
  
  RESULTS
  Mean spherical equivalent (SE) dropped from -18.32 ± 2.37 diopters (D) preoperatively to -0.88 ± 0.52D 5 years postoperatively; 61% of eyes were within ±0.75 D of the target. The mean Snellen decimal CDVA and UDVA were 0.73 ± 0.23 and 0.55 ± 0.26, respectively. More than 50% of eyes achieved 20/25 or better CDVA postoperatively. Four eyes had lost 2 or 1 lines of CDVA, 10 eyes had not lost any lines from preoperatively, and 46 eyes had gained 1 or more lines of CDVA 5 years postoperatively. The safety index was 1.26 ± 0.32. Forty eyes had UDVA of 20/40 or better postoperatively. The efficacy index was 0.99 ± 0.42. At 5-year follow-up, the mean central vault was 475.28 ± 216.38 μm. No eyes showed central contact between the pIOL and crystalline lens. Nevertheless, 10 eyes showed peripheral contact with a central vault between 150 and 260 μm. Two eyes developed anterior subcapsular cataract, although only 1 eye required cataract surgery.
  
  
  CONCLUSIONS
  Predictability, safety and effective outcomes of posterior pIOL of (- were good, as well as postoperative complications over the long term. A central vault of 260 μm was enough to prevent the peripheral contact between the pIOL and crystalline lens in eyes with high myopia.
  
  
  BACKGROUND
  The authors have no proprietary interest in any of the materials mentioned in this article.
authors.affiliation: From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Lisa
authors.affiliation: From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Baamonde
authors.affiliation: From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
authors.forename: Cari
authors.initials: C
authors.lastname: Pérez-Vives
authors.affiliation: From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain.
authors.forename: Robert
authors.initials: R
authors.lastname: Montés-Micó
authors.affiliation: From the Fernández-Vega Ophthalmological Institute (Lisa, Baamonde, Alfonso), Oviedo, Spain; Surgery Department (Baamonde, Alfonso), School of Medicine, University of Oviedo, Spain; GIO (Pérez-Vives, Montés-Micó), Optics Department, Faculty of Physics, University of Valencia, Spain. Electronic address: j.alfonso@fernandez-vega.com.
authors.forename: José F
authors.initials: JF
authors.lastname: Alfonso
mesh_terms: D000328:Adult; D000869:Anterior Eye Segment / Q000473:pathology*; D001699:Biometry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*