Iris and trabecular meshwork pigment changes after posterior chamber phakic intraocular lens implantation
Accepted 5 April 2006.
Purpose
To evaluate the changes in laser iridotomies, intraocular pressure (IOP), angle structures, and pupil diameter after implantable contact lens (ICL) (Version 4 Staar Surgical) implantation in myopic Asian eyes.
Setting
Department of Ophthalmology, Chung-Ang University Yongsan Hospital, Seoul, Korea.
Methods
The ICL was implanted in 81 eyes of 43 patients with spherical equivalent greater than −6.00 diopters. Gonioscopy examination was performed 1 day after laser iridotomy and 6 and 12 months after ICL implantation. The changes in laser iridotomy sites, IOP, and pupil diameter were also evaluated.
Results
Ten eyes (12.3%) had occlusion or narrowing of the laser iridotomy sites. The angle width was more than 30 degrees in all cases preoperatively but narrowed to less than 20 degrees in 16 eyes (19.8%) 6 months postoperatively. The mean pigment, measured by the semiquantitative method (grade 0 to 4), was 2.03 in the inferior angle, 0.18 in the nasal angle, 0.12 in the temporal angle, and 0.00 in the superior angle 12 months postoperatively. The pigment in all quadrants increased temporally as a result of the laser iridotomy or iris rubbing by the ICL; however, the pigments absorbed gradually and decreased to values before laser iridotomy 12 months postoperatively. There was a temporary increase in IOP from the instillation of steroid eyedrops 1 week and 1 month postoperatively; IOP returned to the preoperative level and remained there 12 months postoperatively. There was a significant decrease in pupil diameter 1 and 3 months postoperatively; the diameter returned to the preoperative size at 6 and 12 months. Pigment dispersion syndrome and pigmentary glaucoma were not seen.
Conclusion
Implantation of the ICL narrowed the angle width but did not increase trabecular pigmentation compared with values after laser iridotomy, indicating ICL implantation is safe regardless of the pigmentary changes in the trabecular meshwork.
From the Department of Ophthalmology (Chun, H.I. Lee, Kim), Chung-Ang University Yongsan Hospital, the Department of Ophthalmology (Park), College of Medicine Kyoung, Hee University, and the Chungdam BalGeunSeSang Eye Clinic (J.H. Lee), Seoul, Korea
Corresponding author: Yeoun Sook Chun, MD, Department of Ophthalmology, Chung-Ang University Yongsan Hospital, 65-207, Hangangro-3Ga, Yongsan-Gu, Seoul 140-757, Korea.
Presented at the XXIIIrd Congress of the European Society of Cataract & Refractive Surgeons, Lisbon, Portugal, September 2005.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT