Examining anterior chamber phakic IOL for high myopia

Boston-The hydrophobic, acrylic, anterior chamber phakic IOL (AcrySof Cachet, Alcon Laboratories) performed well in a 5-year study of its safety and efficacy, according to Thomas Kohnen, MD, PhD. Most importantly, he said, the decrease in the corneal endothelial cell count was low and there were low rates of serious adverse events.

The lens is an angle-supported IOL with an optic of 6 mm, lengths ranging from 12.5 to 13.5 mm, and dioptric ranges of 6 to 16.5 D, said Dr. Kohnen, Department of Ophthalmology, Goethe-University, Frankfurt, Germany.

In the international prospective multicenter study that included 360 patients, the mean spherical equivalent was –10.41 D, he said. None of the patients were candidates for refractive surgery. Most patients (87.5%) completed the follow-up at 5 years.

Dr. Kohnen reported that the refractive change over 5 years was less than 0.1 D. The mean preoperative endothelial cell density was 2,857 cells/mm² and decreased to 2,611 cells/mm² 5 years later, which was a –1.1% annual change.  The change in the periphery was –1.6%.

The rates of adverse events-such as iritis, haze, hyphema, retinal detachment, and lens decentration-were all extremely low, he said.  Cataracts developed in 4% of patients, and the loss of corrected visual was 1.1%.

“Compared with all other anterior chamber IOLs, the percentages were very low,” Dr. Kohnen said. “The 5-year results showed maintenance of the corneal endothelial cell count, with a mean annual change of less than 2%. The cells maintained their shape and size.”

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