Correction of Moderate to High Hyperopia With an Implantable Collamer Lens: Medium-term Results

PURPOSE: To evaluate the medium-term results of phakic posterior chamber implantable collamer lens implantation to correct moderate and high hyperopia. METHODS: In this retrospective study, patients were treated for hyperopia with the Visian Implantable Collamer Lens (ICH model V3; STAAR Surgical AG, Nidau, Switzerland). Examined parameters were manifest refraction spherical equivalent, uncorrected distance visual acuity, corrected distance visual acuity, vault, anterior chamber depth, anterior chamber angle width, endothelial cell density, intraocular pressure, patient satisfaction, and complications. RESULTS: The mean age of 15 patients (28 eyes) was 28 years (range: 18 to 36 years), with a mean follow-up period of 3.6 years (range: 3 to 6 years). The mean manifest refraction spherical equivalent decreased from +6.30 +/- 1.42 diopters (D) (range: +4.25 to +8.50 D) preoperatively to -0.37 +/- 0.56 D (range: -1.25 to +1.00 D) at 3 years postoperatively. The mean uncorrected distance visual acuity improved from 0.77 +/- 0.38 logMAR (range: 0.16 to 1.30 logMAR) to 0.20 +/- 0.17 logMAR (range: 0.00 to 0.48 logMAR) at the 3-year follow-up. Postoperatively, 62% of eyes gained one line of corrected distance visual acuity or remained unchanged. The mean vault reduced from 367.1 +/- 253.6 mu m (range: 70.0 to 1,190.0 mu m) at 1 month postoperatively to 283.6 +/- 210.0 mu m (range: 75.0 to 915.0 mu m) at the last follow-up visit (P =.005). The mean preoperative anterior chamber depth and anterior chamber angle width also decreased at the last follow-up visit (P =.037 and <.0001, respectively). The mean endothelial cell loss was 4.91% (P =.089). No serious complications occurred. Thirteen (87%) patients were satisfied with the outcomes and no patient was dissatisfied. CONCLUSIONS: Implantation of a posterior chamber implantable collamer lens is a safe, effective, predictable, and stable method for the correction of moderate and high hyperopia in highly selected patients. No case of cataract or anterior subcapsular opacities formation was recorded in relation to the decrease of vault over the studied period and low vault in some eyes.