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Mireya Arellano; Evaluate the safety and efectiveness of the AcrySof Phakic Angle supported intraocular Lens for the correction of high myopia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3134.
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To evaluate the safety and effectiveness of the AcrySof Cachet Phakic angle-supported Intraocular Lens (pIOL) for the correction of high myopia.
Retrospective and prospective study including patients with high myopia who had implantation of the Acrysoft Cachet pIOL (Alcon Laboratories, Inc., Fort Worth, TX). The outcome measures included uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), endothelial cell density was measured with TOPCON specular microscope SP-2000P (taking 5 measures at the center of the cornea and 25 contiguous cells) , contrast sensitivity (SWCT chart) and adverse effects. The statistical study was made with Wilcoxon test.
We included evaluated 14 eyes of 9 patients with ages from 22 to 53 years, mean 34.1 years; 66.6% were female and 33.3% male. The mean follow up period was 29 months (range 9 to 38 months), with a mean preoperative spherical equivalent of -14.39, ranging from -10.25 to -19.25. The mean postoperative spherical equivalent was -0.5, ranging from -3.25 to +0.62. The mean postoperative UCVA was 20/30 (LogMar 0.17) or better and the BCVA 20/25 (log Mar 0.098 or better. The contrast sensivity was made with CDVA, considering the low, medium or high spatial frequency, mean spatial frequencies were 6.28, 5.07 and 3.78 cycle per degree respectively. The change of the mean preoperative endothelial cell density from 2763.4 cells to a mean postoperative cell density of 2626.9, was statistically significant (p=0.013). Only one patient was steroid hiperreactor, which was normalized after it was suspended. None of the patients showed IOP raised in time or other adverse effects.
AcrySof Cachet showed an effective alternative for the correction of high myopia, it is consistent with other published reports of phakic IOLs, where the UCVA and BCVA were excellent. None of the patients had significant adverse effects. However endothelial cell loss over time was statistically significant, which has been attributed to the proximity of anterior chamber pIOL to the endothelium, the surgery itself and physiology decrease with aging. An important variable to consider is that the procedure was made in our Hospital which has residents in training. Additional follow-up will be necessary to elucidate the long-term effects
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