Iris-fixated phakic intraocular lens implantation after retinal detachment surgery: Long-term clinical results

Abstract

PURPOSE: To assess the efficacy and safety of iris-fixated phakic intraocular lens (pIOL) implantation to correct myopia in eyes with previous retinal detachment (RD) surgery. SETTING: Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, South Korea. DESIGN: Retrospective case series. METHODS: Patients having pIOL implantation in both eyes were enrolled. Eyes that had scleral buckling or encircling (RD group) and healthy fellow eyes (non-RD group) were evaluated over a 6-year follow-up. The corrected distance visual acuity (CDVA), endothelial cell density (ECD), intraoperative complications, and long-term complications were safety outcomes. Uncorrected distance visual acuity (UDVA), predictability, and stability of refraction were efficacy outcomes. RESULTS: The study comprised 34 eyes (17 patients). The mean postoperative CDVA and ECD were not significantly different between groups, and no patient lost CDVA. The rate of transient intraocular pressure spike was significantly higher in the RD group (P=.043). After 3 years and 6 years, the mean postoperative UDVA was 0.06 logMAR +/- 0.09 (SD) and 0.08 +/- 0.10 logMAR, respectively, in the RD group and 0.04 +/- 0.08 logMAR and 0.04 +/- 0.09 log MAR, respectively, in the non-RD group (P=.518 and P=.478, respectively). The rate of eyes within +/- 0.50 diopter of the desired refraction and the postoperative refraction was not significantly different between groups. No eye had vitreoretinal changes requiring secondary surgical intervention. CONCLUSION: Iris-fixated pIOL implantation corrected the myopic refractive error in patients who had scleral buckling or encircling surgery for RD with a high degree of efficacy, safety, and long-term stability.