Intraocular Optical Quality of Phakic Intraocular Lenses: Comparison of Angle-Supported, Iris-Fixated, and Posterior Chamber Lenses

• Published in: American journal of ophthalmology 2013-10, Vol.156 (4), p.789-799
• Main Authors: Alio, Jorge L, Peña-García, Pablo, Pachkoria, Ketevan, El Aswad, Amr
• Format: Article
• Language: English
• Subjects: Aberrometry; Adult; Age; Anterior Chamber - surgery; Design; Eyes & eyesight; Female; Humans; Iris - surgery; Lens Implantation, Intraocular - methods; Male; Middle Aged; Myopia - surgery; Ophthalmology; Optics; Optics and Photonics; Patients; Phakic Intraocular Lenses; Polymethyl methacrylate; Retrospective Studies; Young Adult
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2013.05.013

Purpose To evaluate internal aberrometric profiles following phakic intraocular lens (PIOL) implantation. Design Retrospective and consecutive case series. Methods One hundred and five eyes of 65 patients were included. The optical aberrations were measured with the Topcon KR-1W aberrometer. Comparisons of internal aberrations for different models were made. Comparisons at 4 and 6 mm were made also within the same model for all the lenses. Comparisons regarding the implantation site were also performed: angle-supported (AS) anterior chamber (AC) (n = 47), iris-fixated (IF) (n = 27), and posterior chamber (PC) (n = 31). Results Root mean square (RMS) of internal optical higher-order aberrations (HOAs) changed significantly to higher values from 4-6 mm aperture diameter in each PIOL, as should be expected. However, this significant change was not detected in spherical aberration for Kelman Duet ( P  = .753) and in trefoil for Acrysoft ( P  = .059). Kelman lens showed significantly lower values of spherical aberration compared to Acrysoft at 4 mm ( P  = .022) and at 6 mm ( P  = .042). Acrysoft showed the lowest values at central zone for trefoil ( P  = .043) and tetrafoil ( P  = .002) in AC group. In the IF group, Artisan and Artiflex showed similar results for all internal aberrations. In the comparison between Visian Implantable Collamer Lens (ICL; STAAR Surgical Co, Monrovia, California, USA) and phakic refractive lens (PRL), both for posterior chamber, significantly lower values of coma were observed for ICL ( P  = .033). IF lenses showed clinical evidence, but not significant, of better centering capability than AS lenses ( P  = .096). Conclusions The study of intraocular aberrations is an adequate method to identify the clinical optical behavior and could help the surgeon to identify the most frequent problems related with each model.