Retinal Detachment after Phakic Intraocular Lens Implantation: A 10-Year Multicenter Study.

Abstract

OBJECTIVE\nTo determine the incidence, identify risk factors, and analyze treatment outcomes in eyes with rhegmatogenous retinal detachment following phakic intraocular lens (pIOL) implantation DESIGN: Multi-center, retrospective SUBJECTS: Ten patients with pIOL implantation, who developed rhegmatogenous retinal detachment were included from four different centres.\n\n\nMETHODS\nMedical records of consecutive patients who underwent pIOL implantation at four tertiary eye care hospitals between January 2006 and December 2016 were reviewed. Best-corrected visual acuity (BCVA), anterior segment evaluation, intraocular pressure (IOP), history of prophylactic retinal laser photocoagulation, duration to development of retinal detachment, and details of surgical management of RRD were analyzed.\n\n\nMAIN OUTCOME MEASURES\nPrimary: Visual outcome. Secondary: Mean number of surgery(ies) for retinal reattachment, removal of ICL, and complications in post-operative period RESULTS: One thousand, two hundred and forty-eight (1248) eyes underwent pIOL implantation during the study period, of which 10 eyes (0.8%) developed rhegmatogenous RD. At baseline, mean axial length was 30.19 mm (Range: 28.12 to 32.14 mm), and mean refractive error was -13.21±6.38 (Range: -3D to -20.5D). At presentation with RD, mean BCVA was 1.37±0.84 logMAR (range= 0.18-2.5 logMAR, 20/30-20/60), Mean time to development of RD was 32±35 months (range: 9-40.5 months). Eyes were managed with parsplana vitrectomy and silicone oil injection (n=5), parsplana vitrectomy and intravitreal gas (n=2), scleral buckling (n=2), and pneumatic retinopexy (n=1). One eye had recurrent retinal detachment and underwent repeated surgeries. ICL had to be removed in 2 eyes. Anatomical success with visual improvement was achieved in all 10 eyes. Mean number of surgeries was 1.3±0.94 per eye. Mean post-operative follow-up was 16.83±12.7 months. At last follow-up, mean BCVA was 0.53±0.45 logMAR. Patients were followed-up for mean 47.25± 40.69 months.\n\n\nCONCLUSION\npIOL implantation does not pose a higher risk for RD compared to the normal incidence of RD in myopic eyes. Appropriate vitreoretinal intervention in eyes with high myopia and pIOL can achieve good outcomes.