Implantace intraokulárnízadněkomorové čočky pro fakické okofirmy STAAR Surgical u střednícha vyšších stupňů myopie a hyperopie

Implantation of an Intraocular Posterior-chamber Lens for a Phacik Eye fromSTAAR Surgical Co. in Medium and Higher Grades of Myopia and Hyperopia

Implantation of an intraocular Collamer lens for a phacic eye produced by STAARSurgical (ICL) co. is a modern method of correction of medium and high-graderefractive defects - myopia and hyperopia.The authors evaluate the results of implantation of ICL Staar Surgical in 20 eyesof 13 patients (1 man and 12 women). Their mean age was 31.36 ± 9.21 years andthe follow-upperiod 1-54months(mean28.8months±12.42).Thegroupwasdividedinto two sub-groups - hyperopia (8 eyes) and myopia (12 eyes). The mean value ofrefraction before surgery was +5.28D± 2.03and+0.25 Dcyl manifest (in cycloplegia + 7.6 ± 2.28 D) (from 3.75 D to 10.0 D) in the group of hyperopia and -14.25 D±5.68and -1.81 Dcyl (from -5.5 D to -25.0 D) in the myopic group . The requiredpostoperative refraction was in 17 eyes emmetropia and in 3 eyes residual myopiaupto -3.0Dwithregard to incipient presbyopia.Theauthors evaluate the resultantbest corrected visual acuity (BCVA), the resultant postoperative refraction, theincidence of postoperative complications and changed density of endothelial cellsin the centre of the cornea in the course of time. In the group of hyperopiaimprovement of the BCVA as compared with the preoperative value occurred byone line in two eyes (25%), in 5 eyes(62.5%) BCVA remained unchanged. In oneinstance deterioration by one line occurred due to a diminution of endothelialcells in the centre of the cornea after surgery. In the group of myopia in 7 eyes(58.3%) improvement by 1 line occurred, in 2 eyes (16.7%) by 2 lines and in 3 cases(25%) BCVA remained unchanged.The mean value of postoperative refraction in the myopic group in requiredemmetropia (9 eyes) was -0.77±1.62 D and in required residualmyopia (3 eyes) -1.5± 1.32 D. The mean value of postoperative refraction in the group of hyperopiawas +0.57 ± 0.5 D for far sight and +1.28 ± 0.58 D for near sight.The most frequent early postoperative complications included keratitis striata in5, epithelopathy in 3 and residues of viscoelastic material behind the ICL in 3 eyes.As to late postoperative complications, in 2 eyes a change in endothelial celldensity was involved, in 12 eyes the syndrome of pigment dispersal and in one eyelate decentration of ICL occurred with subsequent anterior subcapsular cataract.The change in density of endothelial cells wasmostmarkedly expressed 3monthsafter surgery in the hyperopic group.The advantage of ICL implantation is rapid postoperative visual rehabilitation,reversibility of the operation, preserved accommodationandsatisfactory stabilityof the postoperative refraction.

Key words:
posterior chamber lens for phacic eye, Collamer, myopia, hyperopia