Comparsion of the Alcon Acrysof Cachet (Anterior Chamber Phakic IOL) and the Visian Implantable Contact Lens (Posterior Chamber Phakic IOL)

1. Frank Howes
2. Michaela Metcalf

Vision group, Queensland, Australia

Purpose:
Study aim to compare refractive outcomes and complications of the Alcon Cachet Phakic IOL and the Visian ICL.

Method:
Retrospective study of 41 Cachet and 210 ICL's.
Parameters examined:
Visual Acuities compared preoperatively and postoperatively in both groups, safety and efficacy values estimated.
Comparisons made in the same dioptric and astigmatic range in both groups.
Assessment and follow up patterns discussed for both groups.
Complications aggregated into early, midterm and late; complications compared where possible in similar time frames in both groups.
All surgery was performed by a single surgeon (FWH) from November 2005 - October 2010

Results:
Both study groups achieved excellent post operative unaided vision. Three months post surgery, 90.48% of Cachet eyes and 90.63% of ICL's measured 6/6 or better on Snellen acuity.
ICL complications included explantation (3.33%), toric rotation (1.91%) peripheral iridotomy light aberration (2.85%), halos (3.81%) and ciliary spasm (4.29%)
The Cachet group complications included 29.73% reporting halos and 21.95% experiencing an IOP spike immediately following surgery. No explantations to date.

Conclusion:
Both these intraocular phakic lenses have firm niches in refractive surgery. The apparent safety of the Cachet suggests that they are the optimal device for dioptric range in which they are available. The ICL completes the range for phakic IOL implantation.