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Abstract #18437 Published in IGR 3-3
Gonioscopic changes after implantation of a posterior chamber lens in phakic myopic eyes
Abela-Formanek C; Kruger AJ; Dejaco-Ruhswurm I; Pieh S; Skorpik CJournal of Cataract and Refractive Surgery 2001; 27: 1919-1925
PURPOSE: To evaluate the effects of posterior chamber implantation of phakic intraocular lenses on angle structures and the correlation with intraocular pressure (IOP). METHODS: A Staar implantable contact lens (ICL) was implanted in 20 white patients (34 eyes) with high myopia. The patients were followed for a mean of 2.3 years (range 0.8-6.0 years). Two subgroups were created: one had a follow-up of 2.4-6.0 years, the other 0.8-2.3 years. The mean spherical power of the implanted ICL was -16.8 diopters (D) (range -9.0 to -21.0 D). The angle structures were examined by gonioscopy using the Spaeth technique, and optical pachymetry and IOP were measured in dilated and undilated pupils. Trabecular pigmentation was measured semiquantitatively. The ICL models included a few prototypes (six eyes), the V2 model (ten eyes), the V3 model (six eyes), and the V4 model (12 eyes). RESULTS: The anterior chamber angle was between 11 and 20° in 41% of eyes, between 21 and 30° in 21%, larger than 30° in 21%, and 10° or smaller in 17%. An apparent iris root insertion was above Schwalbe's line in 6% of eyes, behind Schwalbe's line in 12%, at the scleral spur in 67%, and in a deep angle recess behind the scleral spur in 15%. The curvature of the iris was regular in 19 eyes and steep in 15. The mean pigmentation in all four quadrants was 1.3. (Grade 1 was defined as trace pigmentation.) The mean pachymetry from the endothelium to the ICL anterior surface was 2.7 mm and from the endothelium to the anterior surface of the crystalline lens, 3.2 mm. The mean IOP was 14.1 mmHg in undilated pupils and 12.1 mmHg in dilated pupils. There was no correlation between angle pigmentation and IOP. CONCLUSIONS: Trace pigmentation in the trabecular meshwork was common after ICL implantation. However, there was no direct influence on IOP. Long-term follow-up is necessary to evaluate the effect and progress of trabecular pigmentation in eyes with an ICL.
Dr C. Abela-Formanek, Department of Ophthalmology, Medical School, University of Vienna, Vienna, Austria
Classification:
8.2 Hypermetropia (Part of: 8 Refractive errors in relation to glaucoma)