Position of angle-supported, iris-fixated, and ciliary sulcus–implanted myopic phakic intraocular lenses evaluated by Scheimpflug photography

Purpose

To examine postoperative positional stability of myopic phakic intraocular lenses (IOLs).

Design

Prospective, nonrandomized clinical study.

Methods

The study included 46 eyes which received an anterior chamber angle-supported (Bausch & Lomb NuVita; 10 eyes), anterior chamber iris-fixated (Ophtec Artisan; 20 eyes) or ciliary sulcus–implanted phakic IOL (Staar ICL; 16 eyes). The distance between the phakic IOL and the crystalline lens and the cornea as well as rotation around the optical axis was evaluated using Scheimpflug photography at 1, 3 to 6, and 12 months postsurgery.

Results

The anterior chamber phakic IOLs showed no significant movement in anteroposterior direction. The posterior chamber phakic IOL showed a significant movement toward the crystalline lens between postoperative months 3 and 12. The median amount of rotation around the optical axis between the 3- and the 12-month evaluation was 1.9 degrees (range = 0.0–33.5 degrees) for the NuVita, 0.6 degrees (range = 0.0–3.5 degrees) for the Artisan, and 0.9 degrees (range = 0.2–2.3 degrees) for the ICL. Four NuVita IOLs rotated more than 10 degrees.

Conclusions

The angle-supported anterior chamber phakic IOLs showed a generally stable position regarding distance to cornea and natural lens, but rotation was observed in four IOLs. The iris-fixated phakic IOL showed the highest overall stability. The posterior chamber phakic IOL was stable in terms of rotation but had a tendency to decrease in distance toward the crystalline lens. Intraocular lenses implanted in phakic eyes followed for 12 months demonstrate stable IOL position overall.