Subclinical inflammatory reaction induced by phakic anterior chamber lenses for the correction of high myopia

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Abstract
To ascertain the potential that phakic anterior chamber lenses (PACL) used for the surgical correction of high myopia have for the induction of chronic subclinical inflammatory reaction, the authors have studied prospectively in one year of surgery the presence of subclinical inflammation in the anterior chamber in 18 clinically controlled cases. Nine of them were implanted with the Baik off ZB5M Domilens type and nine with the Fechner-Worst iris claw type. Clinical follow-up and objective measurements were taken with the Laser Flare Cell Meter Kowa FC-1000. In one year of an uncomplicated follow-up flare measurements were 722.52 ± 639.21 (range 0 to 1557.6) for the iris claw and 42.38 ± 91.67 (range 0 to 228.7) for the ZB5M lens (p < 0.01, Mann-Whitney test). Cell measurements were 34.52 ± 22.08 (range 5 to 54.8) for the iris claw and 9.3 ± 11.74 (range 0 to 31.8) for the ZB5M type (p < 0.05 Mann Whitney test). It is concluded that the PACL model ZB5M type is well tolerated in one year of surgery with the induction of marginal levels of flare and cell levels. The Fechner-Worst iris claw type induces unacceptable levels of chronic intraocular inflammation and does not seem suitable for the surgical correction of high myopia. This is the first study that shows that subclinical intraocular inflammation may be present in some models of PACL.