Özet Amaç: Yüksek miyopisi olan hastalarda iris k›skaçl› fakik ön kamara lens implantasyonunun uzun dönem sonuçlar›n› de¤erlendirmek. Gereç ve Yöntem: Yüksek miyopisi olan 34 hastan›n 68 gözü çal›flmaya al›nd›. Tüm hastalara lokal anestezi alt›nda optik çap› 6 mm, tüm çap› 8 mm olan, katlanabilir iris k›skaçl› fakik ön kamara lensi (Artiflex / Veriflex) yerlefltirildi. Takiplerde, refraksiyon de¤erleri, görme keskinli¤i, göz içi bas›nc› (G‹B), endotel hücre say›s› ve geliflen komplikasyonlar

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... erlendirildi. Sonuçlar: Hastalar›n yafl ortalamas› 29,1±7,1 (19 ile 45 y›l) y›l aras›nda idi. Toplam 68 gözün 36's›na Artiflex, 32'sine Veriflex göz içi mercek (G‹M) yerlefltirildi. Ortalama takip süresi 36 ay idi. Hastalar›n ameliyat öncesi ortalama sferik refraksiyon de¤eri -11,5±8,73 D (-7,0 ile -18,0 D aras›), sferik eflde¤eri (SE) -12,1±2,2 D (-7,5 ile -17,5 D aras›) ve düzeltilmifl en iyi görme keskinli¤i (DE‹GK) ortalamas› logMAR 0,35±0,13 idi. Ameliyat sonras› 3. y›lda ise hastalar›n sferik refraksiyon de¤eri ortalamas› -0,53±0,78 D, ortalama SE de¤eri -1,12±0,79 D ve DE‹GK ortalamas› logMAR 0,22±0,18 olarak bulundu. Ameliyat sonras› DE‹GK'da 10 hastada (%14,7) de¤ifliklik olmazken, 57 hastada (%83,87) en az bir s›ra art›fl, bir hastada (%1,47) ise iki s›ra azalma saptand›. Santral korneal endotel hücre kayb› oran› %9,86 bulundu. Takiplerde bir gözde (%1,47) G‹B yükselmesi, üç gözde (%4,4) G‹M'de desantralizasyon, yedi gözde (%10,2) pupil ovalizasyonu ve G‹M üzerinde pigmentasyon, bir gözde (%1,47) ise koroid neovaskülarizasyonu saptand›. Tart›flma: Yüksek miyopisi olan hastalarda uygulad›¤›m›z iris k›skaçl› fakik ön kamara lensi ile refraksiyon, görme keskinli¤i ve hasta konforu aç›s›ndan oldukça tatminkâr sonuçlar al›nd›. (TOD Dergisi 2010; 40: 165-70) Anahtar Kelimeler: ‹ris k›skaçl› lens, Artiflex, Veriflex, yüksek miyopi Summary Purpose: To evaluate the long-term results of iris-claw phakic intraocular lens (IOL) implantation in highly myopic patients. Material and Method: 68 eyes of 34 myopic patients were included in the study. All patients underwent implantation of iris-claw phakic IOL with an optic part of 6 mm in diameter and overall length of 8,5 mm (Artiflex /Veriflex). All surgeries were performed under local anesthesia. During each visit, refraction, visual acuity, intraocular pressure (IOP), endothelial cell changes and complications were evaluated. Results: The mean age of the patients was 29.1±7.1 (range, 19-45) years. In 36 out of 68 eyes, the Artiflex lens was implanted, and in 32 eyes -the Veriflex IOL. The mean follow-up time was 36 months. Before the surgery, the mean spherical refraction of the patients was -11.5±8.73 D (range, -7.0 to -18.0 D), the mean spherical equivalent (SE) was -12. 1±2.2 D (range, -7.5 to -17.5 D), and the mean best-corrected visual acuity (BCVA) was logMAR 0.35±0.13. Three years after surgery, the mean spherical refraction was -0.53±0.78 D, the mean SE was -1.12±0.79 D, and the mean BCVA was log MAR 0.22±0.18. The BCVA was maintained in 10 eyes (14.7%), while 57 eyes (83.87%) gained 1 or more lines of Snellen BCVA and a loss of 2 lines BCVA occurred in one eye (1.47%). The mean corneal endothelial cell loss was 9.86%. During the follow-up visits, one eye (1.47%) had IOP elevation, three eyes (4.4%) had decentration, seven eyes (10.2%) had pupil ovalization and pigment dispersion on the anterior surface of the lens, and in one eye (1.47%) choroid neovascularization was observed. Discussion: Iris-supported phakic anterior chamber IOL implantation in highly myopic patients provides satisfactory visual outcomes and patient comfort. (TOD Journal 2010; 40: 165-70)