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CRISTINA FERNANDEZ-VIGO ESCRIBANO, Ana Macarro Merino, José Ignacio Fernández-Vigo, José Fernández-Vigo López; Laser in situ keratomileusis following the implantation of an angle-supported phakic intraocular lens. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3144.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the safety, effectiveness, predictability, and stability of the combination of an angle-supported phakic intraocular lens (pIOL) implantation and laser-assisted in situ keratomileusis (LASIK) for correcting high myopia and astigmatism.
22 eyes of 14 patients with a preoperative spherical equivalent (SE) between -7.00- and -19.75-diopters (D) were studied. Implantation of an angle-supported pIOL Acrysof Cachet® was done as the first surgery. LASIK was performed at 3 months after pIOL surgery, once stability of topography and refraction were proved. Main outcome measures were uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refraction, applanation tonometry and corneal endothelial study (cell density and coefficient of variation), with a minimum follow-up of 3 months after LASIK.
The mean SE refraction decreases from -11.06±3.25 D before pIOL implantation to -0.68±0.66 D 3 months after pIOL surgery and to -0.15±0.33 D 3 months after LASIK. Snellen Decimal UCVA was 0.53±0.16 3 months after pIOL surgery, increasing to 0.84±0.20 3 months after LASIK. There was an increase in 20/40 or better UCVA from 66.66% after pIOL surgery to 95.23% after LASIK addition. At the final follow-up, SE was within ±0.50 D of emmetropia in 16 eyes (72.72%) and within ±1.00 Din 19 eyes (100%).The mean endothelial cell counts after 3 months after LASIK suggest that no corneal endothelial damage was produced by LASIK itself.
Combine an angle-supported pIOL implantation and LASIK appears to be safe, effective, predictable and a stable procedure to correct eyes with high myopia with astigmatism.
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