Correction of high myopia with the PRL phakic intraocular lens

To assess the predictability, efficacy, safety, and complications of the PRL (CIBA Vision) phakic intraocular lens (pIOL) in the correction of high myopia.

Clínica Oftalmológica Pasteur, Santiago, Chile.

This prospective study comprised 53 eyes of 39 patients who received a PRL pIOL. The spherical equivalent (SE), uncorrected visual acuity (UCVA), efficacy index (postoperative UCVA/preoperative best spectacle-corrected visual acuity [BSCVA]), safety index (BSCVA/preoperative BSCVA), intraocular pressure (IOP), iridocorneal angle, and distance between the crystalline lens and PRL were prospectively assessed during the follow-up period.

The mean patient age was 39 years. The mean power of the implanted pIOL was -12.73 diopters (D) +/- 2.87 (SD) (range -20.00 to -7.00 D), for a preoperative SE of -17.27 +/- 4.58 D (range -31.50 to -8.75 D). The mean preoperative BSCVA was 0.50 +/- 0.70 (logMAR equivalent), and the mean follow-up was 8 +/- 9.4 months. The mean postoperative SE was -0.23 +/- 1.05 D; 71.2% of eyes were within +/-1.00 D. Sixty percent of patients had UCVA of 20/40 or better, and 88.2% of patients had BSCVA of 20/40 or better. Ninety-two percent maintained or gained 1 or more lines of BSCVA; 5.7% lost more than 1 line. There was no significant change in IOP (P = .40), and the mean distance between the crystalline lens and pIOL was 370 microm (ultrasound) and 604 microm (optical coherence tomography). Late complications included 1 case each of retinal detachment and lens subluxation.

Although PRL implantation in high myopia was predictable and effective, retinal detachment and IOL subluxations occurred. Other posterior chamber pIOLs should be used until the complications associated with the PRL pIOL are resolved.