Bioptics in phakic and pseudophakic intraocular lens with the Nidek EC-5000 excimer laser

To evaluate predictability, safety, stability, and complications related to bioptics in patients that received phakic and those that received pseudophakic intraocular lenses. Both groups had LASIK with the Nidek EC-5000 excimer laser following IOL implantation.

We evaluated retrospectively 281 eyes of 196 patients with posterior chamber phakic implantation (ICL) and 64 pseudophakic eyes of 55 patients. All patients had LASIK 1 month or more after the first surgery. We used a treatment zone of 5.5 mm with a 7.00-mm transition zone. The flap was made with the Automated Corneal Shaper (ACS).

In the group of phakic ICL eyes with bioptics, preoperative mean spherical equivalent refraction was -5.50 D (range, -1.37 to -16.00 D). The first day after LASIK, mean spherical equivalent refraction was -0.06 D, and at 1 month, -0.40 D. In pseudophakic bioptics eyes, preoperative mean spherical equivalent refraction was -2.61 D (range, +0.50 to -5.50 D). The first day after LASIK it was +0.27 D, and 1 month after LASIK it was +0.09 D. The incidence of complications was similar in both groups of patients. The most frequent complication was keratitis sicca (approximately 10% in each group). Interstitial edema (2.1%) was present only in phakic bioptics eyes. No retinal complications were observed. Refraction was stable 4 years after surgery. Target achieved refraction was +/- 0.50 D, showing the predictability of the procedure.

Predictability and safety were demonstrated according to results and absence of severe complications related with this technique. Older patients did not develop more complications than younger people; dry eye incidence was similar in both groups. In extreme myopia patients did not present retinal complications related to surgical procedures.