Phakic anterior chamber lenses in very high myopia: an 18-month follow up

Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Design: A prospective interventional case series at the Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey. Participants: Sixty‐two eyes of 31 patients received iris‐claw lens (group 1) (Artiflex AC 401, Ophtec), and 43 eyes of 22 patients received angle‐supported lens (group 2) (I‐Care, Corneal). Methods: The mean preoperative spherical equivalents for group 1 and group 2 were ?12.13 D and ?18.95 D, respectively. Endothelial cell density was measured at day 1 and at 1, 3, 6, 12 and 18 months for follow ups. Main Outcome Measures: Percentage change in endothelial cell density and improvement in visual acuity. Results: At the 18‐months follow up, uncorrected visual acuity improved to logMAR 0.37 ± 0.23 from 1.60 ± 0.10 in group 1, and logMAR 0.47 ± 0.14 from 0.70 ± 0.20 in group 2; best spectacle corrected visual acuity improved to logMAR 0.23 ± 0.22 from logMAR 0.36 ± 0.14) in group 1, and logMAR 0.29 ± 0.18 from logMAR 0.50 ± 0.20) in group 2 (P < 0.001, in both groups). Mean decreased endothelial cell density was 241 cells/mm² (8.61%) and 223 cells/mm² (8.42%) at 18 months follow up in group 1 and 2, respectively (P = 0.17) but significant in comparison to preoperative values for both groups (P < 0.001). Conclusions: Although both iris‐claw and angle‐supported lenses offer good refractive outcomes significant endothelial cell density was observed at 18 months follow up.