IRIS CLAW PHAKIC INTRAOCULAR-LENS FOR HIGH MYOPIA

BACKGROUND: The implantation of a Worst-Fechner iris claw intraocular lens (IOL) is one of the surgical procedures used for the correction o f high myopia. This technique reduces myopia with stable refractive re sults; however, its potential long-term risks have not been evaluated. We report results in 94 eyes with a minimum follow-up of 3 years. MET HODS: We studied 94 eyes of 62 patients with myopia greater than or eq ual to -7.00 diopters (D) who underwent Worst-Fechner IOL implantation . Lens decentration, permeability of the blood-aqueous barrier by iris angiography, and changes in corneal endothelial density were analyzed . RESULTS: Mean follow-up time was 48.9 months (range 36 to 72 mo). Th ree years after surgery, 58 eyes (61%) had an uncorrected visual acuit y greater than or equal to 20/40, and 77 eyes (82%) gained two or more lines of spectacle-corrected visual acuity with respect to the preope rative value; 75 eyes (79%) were within +/-1.00 D of emmetropia and 46 eyes (48%) were within +/-0.50 D of emmetropia. The mean endothelial cell loss was 17.9% at 5 years after surgery, while the percentage of hexagonality and the coefficient of cell variation tended toward preop erative levels. No vision threatening complications were seen. CONCLUS IONS: The implantation of a Worst-Fechner iris claw phakic IOL reduced high myopia with a stable refractive outcome. Endothelial cell damage was within acceptable limits. The absence of major complications make s this procedure an acceptable method for correcting high myopia.