Combined surgery to correct high myopia: Iris claw phakic intraocular lensand laser in situ keratomileusis

PURPOSE: To evaluate the results of combined surgery, implantation of an Ar tisan phakic iris claw intraocular lens (IOL) followed by laser in situ ker atomileusis (LASIK) to correct high myopia. METHODS: A prospective study of 6 patients (8 eyes) with high myopia who ha d Artisan phakic IOL implantation followed by LASIK was undertaken. The IOL was a standard -15.00-D, 6-mm diameter optical zone. Residual refractive e rror was corrected by LASIK. Mean follow-up was 16 +/- 4 months (range, 12 to 20 mo). RESULTS: After the second procedure (LASIK), uncorrected visual acuity rang ed from 0.4 to 0.63 (mean, 0.5 +/- 0.07) at 1 month and from 0.6 to 0.7 (me an, 0.62 +/- 0.04) at 12 months. Spectacle-corrected visual acuity improved 2 or more lines in 62.5% (5 eyes) from preoperative values. Mean postopera tive spherical equivalent refraction was -0.68 +/- 0.23 at 1 month and -0.3 5 +/- 0.22 at 12 months after LASIK. All eyes were within +/- 1.00 D of emm etropia following the LASIK portion of the two-stage procedure and 5 eyes w ere within +/- 0.50 D. We had no major complications. No significant endoth elial damage occurred. CONCLUSIONS: The accurate refractive outcome, absence of major complication s, stability of results, and most important, improvement in quality of visi on (defined as no change in vision when illumination conditions varied, eg, at night) experienced by these highly myopic patients are reasons to conti nue using and improving this combined technique.