[Refractive phakic IOLs: three different models and contact with the crystalline lens. An AC-OCT study]

Area of Science:

• Ophthalmology
• Medical Imaging
• Refractive Surgery

Background:

• Phakic implants are intraocular lenses surgically placed in front of the natural lens.
• Assessing contact between phakic implants and the natural crystalline lens is critical for patient safety.
• Traditional slit-lamp examination has limitations in visualizing this specific interaction.

Observation:

• Three patients with different phakic implant models were examined.
• Slit-lamp examination could not definitively confirm or deny implant-lens contact.
• Anterior chamber optical coherence tomography (AC-OCT) was employed for high-resolution imaging.

Findings:

• AC-OCT successfully demonstrated direct physical contact between the natural crystalline lens and all three types of phakic implants.
• Dynamic analysis during accommodation revealed ongoing interactions at the point of contact.
• The study highlights the sensitivity of AC-OCT in detecting subtle anterior segment structures.

Implications:

• AC-OCT is an essential tool for comprehensive pre- and post-operative evaluation in refractive surgery involving phakic implants.
• This imaging modality can help identify potential risks of implant-induced complications.
• Routine use of AC-OCT may improve patient outcomes and surgical safety in phakic IOL procedures.