Risk factor evaluation for cataract development in patients with low vaulting after phakic intraocular lens...

To evaluate the occurrence of cataract in eyes with low vaulting after phakic intraocular lens (pIOL) implantation for myopia and suggest guidelines for such cases.

Samsung Medical Center, Seoul, Korea.

Cross-sectional study.

Eyes with low Implantable Collamer Lens pIOL vaulting (<250 μm) were followed 1, 3, and 6 months as well as 1, 2, 3, and 4 years postoperatively. Frequency and time to cataract development were evaluated. Risk factors for cataract development were assessed using logistic regression analysis. Cutoff values for differentiating eyes at higher risk for cataract development were evaluated using Fisher exact and chi-square tests.

Cataract developed in 8 (30.8%) of 26 eyes (6 of 20 patients) a mean of 18.7 months ± 10.1 (SD) postoperatively. Risk factors that were significant for cataract formation included lower vaulting (mean 42.4 ± 34.0 μm versus 141.4 ± 82.2 μm; odds ratio [OR], 1.05), older age (mean 42.6 ± 7.3 versus 34.9 ± 6.9 years; OR, 1.22), and higher preoperative spherical equivalent (SE) (mean -17.1 ± 4.4 diopters [D] versus -10.7 ± 2.7 D; OR, 1.64). The optimum cutoff values were 51.7 μm, 45 years, and -14.00 D (P=.0095, P=.0367, and P=.0342 respectively).

In cases of low pIOL vaulting, close follow-up should be considered when central vaulting is less than 52 μm, patient age is more than 45 years, or the preoperative SE is greater than -14.00 D because these factors increase the risk for cataract.