Visual Outcomes After Sequential Posterior Chamber Phakic IOL with Corneal Refractive Surgery (Bioptics) for the Treatment of Myopic Astigmatism

Majid Moshirfar; Robert J Thomson; William B West Jnr; Shannon E McCabe; Thomas M Sant; Margaret H Shmunes; Yasmyne C Ronquillo; Phillip C Hoopes

doi:10.2147/OPTH.S285140

Visual Outcomes After Sequential Posterior Chamber Phakic IOL with Corneal Refractive Surgery (Bioptics) for the Treatment of Myopic Astigmatism

Clin Ophthalmol. 2020 Dec 9:14:4337-4346. doi: 10.2147/OPTH.S285140. eCollection 2020.

Authors

Majid Moshirfar^{1

2

3}, Robert J Thomson⁴, William B West Jnr⁵, Shannon E McCabe^{1

6}, Thomas M Sant⁵, Margaret H Shmunes⁷, Yasmyne C Ronquillo¹, Phillip C Hoopes¹

Affiliations

¹ Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA.
² John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
³ Utah Lions Eye Bank, Murray, UT, USA.
⁴ McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.
⁵ University of Utah School of Medicine, Salt Lake City, UT, USA.
⁶ Mission Hills Eye Center, Pleasant Hill, CA, USA.
⁷ Burrell College of Osteopathic Medicine, Las Cruses, NM, USA.

Abstract

Purpose: To report the outcomes of sequential posterior chamber phakic intraocular lens (PC-pIOL) with corneal refractive surgery in conventional (PC-pIOL prior to refractive surgery) and reverse (refractive surgery prior to PC-pIOL) bioptics for treating high myopic astigmatism.

Setting: Tertiary refractive center, Draper, Utah, USA.

Design: Retrospective case series.

Methods: Medical records of patients who underwent planned bioptics were reviewed. Surgery involved PC-pIOL placement using an implantable collamer lens (ICL) with preceding or subsequent LASIK or PRK. Pre- and postoperative manifest spherical equivalent (SEQ), visual acuity, and PC-pIOL vault were analyzed.

Results: Of the 51 eyes present at 12 months postoperatively, 49 eyes (96%) achieved target SEQ within ±1.00 D and an identical amount achieved refractive astigmatism ≤1.00 D. Post-bioptics eyes achieved a postoperative UDVA equal to or better than preoperative CDVA in 45 eyes (88%). Efficacy and safety indices were 1.08 ± 0.20 (41 eyes) and 1.13 ± 0.22 (44 eyes) for conventional bioptics and 0.99 ± 0.42 (7 eyes) and 1.15 ± 0.38 (7 eyes) for reverse bioptics eyes at 12 months. The maximum PC-pIOL vault of conventional bioptics eyes (27 eyes) within 6 months before and after LASIK/PRK was 385 ± 159 μm and 377 ± 135 μm, respectively (P = 0.71).

Conclusion: Bioptics for high myopic astigmatism was safe and effective. Reverse bioptics, although not as traditional, could provide similar results. Additionally, the PC-pIOL vault does not appear to be affected by LASIK/PRK.

Keywords: LASIK; PRK; bioptics; high myopic astigmatism; posterior chamber phakic IOL; visual outcomes.

Grants and funding

This study was funded by an unrestricted grant from Research to Prevent Blindness (RPB), 360 Lexington Avenue, 22nd Floor New York, NY 10017. No support was received for the publication of this article.