Worst-Fechner biconcave minus power phakic iris-claw lens

OBJECTIVE: Evaluation of long-term results of correction of high myopia by implantation of a biconcave Worst-Fechner minus power iris-claw lens into p hakic eyes. METHODS: One hundred and twenty-seven eyes of 70 patients were implanted wi th the phakic IOL between November 1986 and November 1991. The mean preoper ative spherical equivalent refraction was -14.29 +/- 5.77 D (range -5.00 to -31.75 D). The total population decreased from 127 to 68 eyes (53.5%) at t he 8-year examination. By this time, 26 of the 70 patients (37%) had been l ost to follow-up for unknown reasons. Corneal endothelial density was estim ated by comparing the image gained by noncontact specular microscopy with a graduated reticule (Karickhoff method). RESULTS: At the B-month examination, mean deviation of achieved from calcul ated refractive correction was +0.52 +/- 1.46 D (range -2.25 to +6.50 D). S eventy-seven eyes (62.1%) deviated 1.00 D or less, and 15 eyes (12.1%) devi ated by more than 2.00 D from the calculated correction. A refractive outco me of +/-1.00 D was attempted in 68 eyes (54% of the 124 eyes) and was achi eved in 51 eyes (75%). Mean spectacle-corrected visual acuity preoperativel y was 0.54 +/- 0.27 (range 1.20 to 0.05). At the 6-month examination it was 0.73 +/- 0.3, and by the 8-year examination had decreased to 0.65 +/- 0.26 . Statistical analysis of corneal endothelial cell density revealed a signi ficant correlation of endothelial cell loss with age (greater than or equal to 45 years), anterior chamber depth (less than or equal to 3.4 mm), and I OL power (greater than or equal to.11.00 D). Seventeen eyes (13.4%) had a d ecrease in endothelial cell density and projection to 8-year follow-up resu lted in a decrease in 27% of eyes. Four eyes needed a penetrating keratopla sty. CONCLUSION: Implantation of a biconcave Worst-Fechner lens into a phakic ey e effectively corrected high myopia with a stable refractive outcome, but 1 3.4% of implanted eyes suffered significant progressive reduction of endoth elial cell density. This style lens is no longer in clinical use.