Follow-up Study of More Than 15 Years of an Angle-Supported Phakic Intraocular Lens Model (ZB5M) for High Myopia: Outcomes and Complications

IMPORTANCE This study confirmed the long-term outcomes of the ZB5M phakic intraocular lens (PIOL). OBJECTIVE To evaluate the potential long-term risk associated with ZB5M PIOL implantation. DESIGN, SETTING, AND PARTICIPANTS A retrospective, nonrandomized, consecutive cohort study of a total of 208 eyes implanted with ZB5M PIOLs at VISSUM Corporación Oftalmológica de Alicante between 1990 and 1996 identified through surgical records (208 eyes of 123 patients); 50 of these patients (97 eyes) had available records and follow-up. INTERVENTION ZB5M PIOL implantation. MAIN OUTCOMES AND MEASURES To evaluate the incidence and onset of each complication during the follow-up and risk factors and causes for loss of visual acuity. RESULTS Mean (SD) preoperative spherical equivalent refraction was −19.36 (6.7) diopters and at the end of follow-up, it was −1.4 (2.6) diopters. Mean (SD) best-corrected visual acuity at the preoperative visit was 0.35 (0.2) decimal and at the end of follow-up, 0.56 (0.3) decimal. Mean (SD) endothelial cell density preoperatively and at the end of follow-up was 2783 (787) cells/mm2 and 1921 (672) cells/mm2, respectively. The incidence of cataract during the follow-up was 0.010 eye-year (EY); cornea decompensation, 0.001 EY; ocular hypertension, 0.008 EY; pupil ovalization, 0.020 EY; uveitis, 0.001 EY; and retinal detachment, 0.002 EY. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study that describes the long-term outcomes and complications of ZB5M PIOLs and suggests increasing the postoperative follow-up examinations in patients older than 40 years, analyzing anterior chamber modifications, and recommends PIOL explantation in cases of an increase in the crystalline size.