New phakic IOL with central hole shows good outcomes for high myopia

This pilot study found that correction of myopia with a new-model posterior chamber Implantable Collamer Lens phakic IOL (V4c, Visian, Staar Surgical Co.) with a central hole was effective, predictable, safe and stable.

The central hole allows flow of the aqueous humor from the posterior chamber to the anterior chamber without the need for peripheral iridotomies.

The study demonstrated that the IOL allowed for normal postoperative IOP without loss of central visual acuity. The modified lens appears to represent an important advance in the safety of posterior chamber phakic IOLs.

The study included 70 patients (138 eyes) implanted with the IOL. The mean spherical equivalent decreased from -8.73 D preoperatively to -0.03 D six months postoperatively. Ninety-six percent of eyes were within ±0.50 D and 100 percent of eyes were within ±1.00 D. The mean UDVA and CDVA were 20/20 or better in 92.1 percent and 95 percent of eyes, respectively, at six months. The safety and efficacy indices were 1.01 and 1.00, respectively.

Postoperatively, IOP remained stable over time. No significant rises in IOP, including pupillary block, and no secondary cataract were found. After six months, the mean vault was 482.7 µm (range 90 to 970 µm) and the mean endothelial cell loss was 8.5 percent.

The authors conclude that the V4c Visian IOL is a reliable alternative to correct moderate to high myopia.