الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 116 |  |  |
| | | from | 116 | | |
Abstract
The prevalence of myopia is very high. Most patients seeking refractive surgery treatments suffer from moderate to high myopia. Laser corneal refractive surgeries to correct myopia have gained wide acceptance worldwide. However, the surgery is not safe for patients with high level of refractive error and relatively thin corneas, as these conditions could increase the risk of postoperative corneal ectasia.
Phakic intraocular lens implantation could correct a wider range of refractive errors and avoid decreases in corneal thickness; therefore, it would be a good option for patients with these conditions. Even in eyes with keratoconus, the phakic IPCL was found to be effective in correcting high myopic astigmatism.
The ultimate goal of this study was for assessment of angle of anterior chamber by anterior segment optical coherence tomography before and after implantable phakic contact lens in high myopia, in an attempt to achieve better management for such condition.
This study was a prospective interventional trial908 that was carried out on 20 eyes of 11 patients with high myopia, who were not amenable to laser refractive surgery correction, the patients divided into two groups: group A: Ten eyes from – 7 D to – 12 D. group B: Ten eyes from more than – 12 D to – 20 D, all patients consecutively scheduled for IPCL implant to treat myopia.
All patients were subjected to complete history taking include: Personal history as; name, age, sex, occupation, residence. Present history as; onset, course, and duration of myopia, and visual loss. Past and family history of any ocular disorders, chronic illness or associated disease either
involving the eye or other system. Medical history of oral, topical medications, or history of previous ocular surgery.
General examination, was obtained to exclude medical conditions that increase the risk of intraoperative and postoperative complications, and also to exclude systemic conditions that are usually associated with rising of IOP. Detailed ocular examination was obtained in order to define (UCVA), (BCVA), refractive error, anterior slit-lamp biomicroscopy, posterior segment ophthalmoscopy IOP was measured by the Goldmann Applanation Tonometer. The Pentacam was used for measurement of anterior chamber depth. For iridocorneal angle measurements, we used anterior segment optical coherence tomography (AS‑OCT) imaging for iridocorneal angle dimensions. Under mesopic conditions with the device’s software set to Angle mode.
All patients scheduled for IPCL implant under topical anesthesia using, with achievement of pupillary dilatation. A temporal 3.2 mm clear corneal incision was made using keratome. The IPCL was loaded into the cartridge and injected into the AC. At the end of the surgery, a standard postoperative regime consisting of topical prednisolone acetate 1% four times a day for 5 days tapering over 2 weeks and topical moxifloxacin 0.5% four times a day for 2 weeks was followed.
The patient was followed up regularly at 1 week after the surgery. UCVA, BCVA, IOP, angle parameters were measured during followed up period.
With reference to demographic data of the studied patients, we found no significant difference between studied groups as regard age, sex, and the affected eye.
With reference to anterior segment parameters, we found significant reduction in angle of anterior chamber, after IPCL implantation, with no significant difference between studied groups.
With reference to visual acuity, we found significant reduction in both sphere, cylinder BCVA, and UCVA, after IPCL implantation, with no significant difference between studied groups.
Conclusion
from our study we can conclude that, IPCL implantation for correction of high myopia leads to significant changes in the anterior chamber angle, volume and depth. It is safe and effective for the correction of high myopia specially, who were not suitable for other refractive surgery correction.