Abstract
Objective
Case series of haptic migration in patients with angle-supported phakic anterior chamber
intraocular lens (PAC-IOL: Phakic6H) through the superior peripheral iridectomy (PI).
Methods
Charts of 23 patients (35 eyes) with at least 6 months’ postoperative follow-up were retrospectively reviewed. Evaluation
included preoperative and postoperative cycloplegic and manifest refractions, uncorrected
visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp examination,
fundoscopy, corneal topography, and biometry.
Results
Mean UCVA was 1.67 ± 0.30 (1.17–2.00) for all 35 eyes preoperatively and 0.35 ± 0.25
(0.00–1.00) postoperatively (p < 0.001; 95% CI 1.21–1.44). BCVA had a mean of 0.31 ± 0.26 for all 35 eyes preoperatively,
and a mean of 0.22 ± 0.25 postoperatively (p < 0.001; 95% CI 0.04–0.14). Haptic migration into the superior PI was noted in 8
eyes (23%). The first migration was noted 2 years postoperatively and the last 8 years
after implantation (mean, 5.6 ± 2 years). There was no statistically significant difference
in the BCVA and UCVA before and after haptic migration. Follow-up ranged from 8 months
to 8.5 years.
Conclusions
Angle-supported PAC-IOL implantation resulted in significant improvement in both UCVA
and BCVA. However, there is a 23% incidence of haptic migration in our series with
no sequelae on BCVA or harmful effect on the intraocular structures. This IOL movement
may be explained by changes in aqueous dynamics at the level of the PI leading to
migration of the haptic into the area of least resistance.
Objectif
Étudier des cas de migration de l’haptique dans le site de l’iridectomie périphérique
(IP) supérieure après l’implantation de lentilles intraoculaires phaques (LIOP) à
support angulaire dans la chambre antérieure (Phakic 6H®).
Méthodes
On a examiné rétrospectivement les dossiers de 23 patients (35 yeux) ayant fait l’objet
d’au moins 6 mois de suivi postopératoire. Éléments évalués: réfraction sous cycloplégie
et réfraction manifeste préopératoires et postopératoires, acuité visuelle non corrigée
(AVNC), meilleure acuité visuelle corrigée (MAVC), examen à la lampe à fente, fondoscopie,
topographie cornéenne et biométrie.
Résultats
L’AVNC moyenne était de 1,67 ±0,30 (1,17-2,00) avant l’intervention et de 0,35 ±0,25
(0,00-1,00) après l’intervention (P <0,001; IC 95 %, 1,21-1,44). La MAVC moyenne était
de 0,31 ± 0,26 avant l’intervention et de 0,22 ± 0,25 après l’intervention (P <0,001;
IC 95 %, 0,04-0,14). Il y a eu migration de l’haptique dans le site de l’IP supérieure
pour 8 yeux (23 %). La première migration a été notée 2 ans après l’intervention et
la dernière, 8 ans après l’implantation (moyenne de 5,6 ± 2 ans). Il n’y avait pas
d’écart statistiquement significatif entre les MAVC et les AVNC avant et après la
migration de l’haptique. La durée du suivi allait de 8 mois à 8,5 ans.
Conclusions
L’implantation de LIOP à support angulaire dans la chambre antérieure a donné lieu
à une amélioration significative de l’AVNC et de la MAVC. Cependant, il y a eu parmi
les cas étudiés une incidence de 23 % de migration de l’haptique, sans séquelles pour
la MAVC ni effet nocif sur les structures intraoculaires. Le déplacement des LIO pourrait
découler de variations de la dynamique aqueuse au niveau de l’IP, entraînant une migration
de l’haptique vers l’endroit où la résistance est la moindre.
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Article info
Publication history
Accepted:
October 28,
2015
Received in revised form:
October 18,
2015
Received:
April 21,
2015
Identification
Copyright
© 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
