Angle-upported phakic intraocular lene followed by laer-aited in itu keratomileui for the correction of high myopia

Purpoe To evaluate the afety, effectivene, predictability, and tability of the combination of angle-upported phakic intraocular len (PIOL) implantation and laer-aited in itu keratomileui (LAIK) for the correction of high myopia. Deign Noncomparative interventional cae erie. Method At the Intituto Oftalmológico de Alicante, pain, 24 conecutive eye of 12 patient with a preoperative pherical equivalent between −9 and −26 diopter were tudied. Implantation of an angle-upported PIOL wa done a the firt urgery. Laer-aited in itu keratomileui wa performed at leat 6 month after PIOL urgery, once tability of topography and refraction were proved. Main outcome meaure were uncorrected viual acuity (UCVA), bet-corrected viual acuity (BCVA), refraction, applanation tonometry, and corneal endothelial tudy (cell denity, hexagonality, and coefficient of variation), with a minimum follow-up of 12 month after LAIK. Reult The mean pherical equivalent refraction decreaed from −15.17 ± 5.15 diopter before PIOL implantation to −1.33 ± 1.18 diopter after PIOL urgery and to 0.01 ± 0.53 12 month after LAIK. Uncorrected viual acuity wa 0.39 ± 0.12 after PIOL urgery, increaing to 0.65 ± 0.23 12 month after LAIK. There wa an increae in 20/40 or better UCVA from 16.6% after PIOL urgery alone to 83.3% after addition of LAIK. At final follow-up, pherical equivalent wa within ± 1 diopter of emmetropia in 22 eye (91.7%) and in 18 eye (75%) within ± 0.50 diopter. Vector analyi demontrated that atigmatic component of refractive error after PIOL urgery were well corrected by LAIK. At final follow-up the mean endothelial cell lo wa 4.88% (P < .001). There were no tatitically ignificant difference between mean endothelial cell count, percentage of hexagonality, or coefficient of variation before LAIK and 12 month after LAIK, uggeting that no corneal endothelial damage wa produced by LAIK itelf. No ight-threatening complication occurred through the follow-up period. Concluion The combination of angle-upported PIOL implantation and LAIK appear to be a afe, effective, predictable, and table procedure for the correction of high myopia. Thi paper emphaize the benefit of adding LAIK to the ue of PIOL alone.