Comparison of the Visian Implantable Collamer Lens with the Verisyse Phakic Intraocular Lens in High Myopia Jigna Joshi MD Marian Macsai MD Parag Majmudar MD Vanee Virasch MD A Collaboration between Northwestern and Rush University Dr. Macsai is a member of the speakers bureau for Allergan and Alcon. Dr. Majmudar is a consultant for AMO.

Purpose To compare outcomes of the Visian Implantable Collamer Lens with the Verisyse Phakic Intraocular Lens in patients with high myopia

Methods A retrospective chart review of consecutive patients implanted with a phakic intraocular lens by one of two experienced surgeons.

Results Number of eyes Mean Age Sex Average follow up Verisyse 62 38 36 Female 26 Male 11 months Visian 22 43 20 Female 2 Male

Results Pre-operative Spherical Equivalent Target Refraction Post Operative Spherical Equivalent Average post operative UCVA Verisyse -12.50 (-7.5 to -27.75) -0.10 -0.41 20/37 Visian -11.00 (-7 to -13.50) -0.18 +0.25 20/33

Results Average Pre Operative Endothelial Cell Count Average Post Operative Endothelial Cell Count Verisyse 3412 2768 Visian 2482 2771

Results Average loss of endothelial cells in the first 12 months was 4.4% in the Verisyse group and 2.5% in the Visian group. Six (6) patients (8%) in the Verisyse group required enhancements with either PRK or LASIK Four (4) patients (7.1%) in the Visian group required enhancement with LASIK.

Results Three eyes required enlargement of Yag peripheral iridotomies within the first post operative month in the Visian group. Four eyes developed mild peripheral anterior subcapsular opacities that were not visually significant in the Visian group. No lenses required explantation

Limitations Small sample size Endothelial cell counts in the Verisyse group were measured by two different techniques, one pre-op and one post-op, resulting in higher variability in that group The inherent difference in lens position will result in different complications

Conclusion Visual outcomes were similar in both intraocular lens groups. Enhancement rates for residual refractive errors were similar in both intraocular lens groups. Rate of endothelial cell loss was greater in the Verisyse, while the Visian group had more capsular opacities (visually insignificant).

Conclusion The Visian ICL and the Verisyse Phakic IOL appear to be safe alternatives for the treatment of high myopia. Post market approval outcomes are helpful for physicians considering including these techniques in their practice.