| ObjectiveTo observe the clinical effects and complications of the implantation of the Verisyse phakic iris-fixated intraocular lens (PIOL) for the correction of high myopia with astigmatism in China, with its main incision placed at the steeped corneal meridian decided by corneal topography, evaluate the visual quality of the eye before and after the insertion of an Verisyse phakic lens, and to offer another choice for the correction of high myopia. Methods20 patients(30 eyes) implanted the Verisyse phakic iris-fixated intraocular lens were selected in our eye center between June 2005 and March 2006. Preoperative myopia ranged from -8.25 diopters(D) to -26.25D, cylinder ranged from -0.5D to -3.5D, preoperative uncorrected visual acuity (UCVA) ranged from 0.02 to 0.3, best corrected visual acuity (BCVA ) ranged from 0.3 to 1.5, 6 (8 eyes) of male and 14(22 eyes) of female, age ranged from 20 years to 40years (mean: 35±4.5 years ). The main incision was made at the steeped corneal meridian decided by corneal topography, which was biplane, un-sutured. Preoperative and postoperative visual acuity, refraction, corneal astigmatism, intraocular pressure, corneal endothelium, contrast sensitivity, glare sensitivity, wavefront aberration, ultrasound biomicroscopy (UBM ) and operative complications were observed.ResultsAll of 30 eyes were implanted successfully and have been followed up for 6 months. The preoperative UCVA was not better than 0.3 in all patients. Apostoperative UCVA of 0.5 or better was observed in 100% eyes (30/30) and a BCVA of 0.8 or better was observed in 86.7% (26/30) eyes at 6 months, and they were all significantly better than that of preoperative values (P<0.05); 40%(12/30) gained≥2 lines of BCVA.At 3 and 6 months postoperative, the spherical equivalent refractions(SE) was (-0.75±0.37)D and (-0.71±0.40)D respectively, 93.3%(28/30) of eyes were within±1.0D of the desired refraction, 66.7%(20/30) were within±0.5D. The corneal astigmatism of (1.33±0.73)D preoperative was decreased to (0.83±0.46)D significantly at 6 months, and the corneal topography showed that the corneal meridian main incision placed was flatted.The postoperative contrast sensitivity and glare sensitivity in all spatial frequencies increased compared with those of preoperative values, especially at low and midrange spatial frequencies. The root mean square (RMS) of total wavefront aberration decreased from (1.52±1.50) m preoperative to (1.27±0.86) m postoperative (P>0.05), the RMS of higher order aberration (HOA) increased from (0.50±0.22) m to (0.70±0.42) m slightly(P>0.05).Echograms of the anterior chamber were taken preoperatively and 6 months postoperatively in all eyes implanted with the Verisyse PIOL. The PIOL were corrected positioned on the midperipheral of the iris postoperatively, The mean distance between the central cornea and the anterior surface of the PIOL was (2.16±0.42)mm; between the posterior surface of PIOL and the lens, (0.66±0.10)mm; and between the distal end of haptics and the angel of anterior chamber, (1.51±0.35)mm; and between edge of the optics and the peripheral cornea, (1.51±0.30)mm.Less complications were observed, There were no statistically significantly difference between preoperative and postoperative mean intraocular pressure,corneal endothelial density (P>0.05).Conclusions1. The implantation of Verisyse with the modified operative incision decided by corneal topography can decrease the preoperative corneal astigmatism effectively.2. Implantation of the Verisyse iris-fixated PIOL in phakic eyes to correct high myopia with astigmatism was effective, less complications was observed and the visual quality was improve obviously, inducing less HOAs and increasing postoperative visual acuity and contrast sensitivity. but its long-time follow-up is still required. |
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