Objective: To evaluate the safety and the long term results of anterior chamber phakic lens, Phakic 6 Refractive, for myopia correction.
Methods: In this retrospective study we reviewed the charts of 35 myopic patients (62 eyes) who had implantation of anterior chamber phakic lenses (Phakic 6 Refractive, Ophthalmic Innovations International, California, USA) for correction of myopia. The mean age of patients was 26 years (18 to 45 years). The mean spherical refraction was -9.9 (-4 to -18 D). The best corrected distant visual acuity (BCDVA) was 0.92 (1.2 to 0.3) before surgery. The mean follow-up was 8 years (4 to 10). The mean endothelial cell count was 2481 cells/mm2 and the mean pachymetry was 540 μm before surgery. In those patients who needed a second surgical intervention (explantation or lens reposition) the last follow-up visit is the visit before the lens explantation or reposition. The same surgeon (P. R.) performed all surgeries and used the same technique in each surgery.
Results: On the final follow up visit the BCDVA was in the mean 1.02 (1.5 to 0.5). The spherical refraction was in the mean – 0.53 D (-3.0 to +1.0). We noticed a 16% decrease in the mean number of corneal endothelial cells, and no change in the pachymetry values. We had to explant the lenses in 7 eyes (12 %) because of the decreased endothelial cells count. 2 eyes (3.0 %, 1 patient) had to receive treatment for glaucoma, 4 eyes (6.5 %) had to have the artificial lens repositioned, 1 patient had to have photocoagulation therapy for a retinal tear. 93 % of the study eyes had stable refraction during the study period. There was a 10 % increase in the average BCDVA, and there as a 95 % improvement of the original refractive error.
Conclusions: In selected cases, the implantation of Phakic 6 Refractive anterior chamber lens is a viable option despite it is currently largely abandoned.