Beyond visual acuity: one-year refractive and vision-related quality-of-life outcomes after phakic intraocular lens surgery in highly myopic eyes

This study aimed to evaluate refractive outcomes, changes in ocular biometric parameters, and visual quality following implantation of a posterior chamber, foldable, hydrophilic acrylic Eyecryl Phakic intraocular lens (PIOL) in patients with high myopia. In addition, the effect of the procedure on vision-related quality of life was assessed using the National Eye Institute Visual Function Questionnaire–25 (NEI-VFQ-25). Our study included 51 eyes of 26 patients with high myopia who underwent Eyecryl PIOL implantation. Inclusion criteria were age ≥ 20 years, stable refraction, anterior chamber depth ≥ 2.8 mm, and endothelial cell density ≥ 2000 cells/mm². Preoperative data and 1-year postoperative findings were analyzed. Evaluated parameters included best-corrected visual acuity (BCVA), manifest refraction, intraocular pressure (IOP), anterior chamber depth (ACD), and endothelial cell density (ECD). Subjective visual performance and quality of life were assessed using the NEI-VFQ-25 questionnaire. The mean spherical equivalent improved significantly from − 13.24 D preoperatively to + 0.19 D postoperatively ( p < 0.001). The mean postoperative uncorrected visual acuity was 0.05 ± 0.05 logMAR. The mean BCVA improved from 0.22 to 0.02 logMAR ( p < 0.001). At 1-year follow-up, 60% of eyes were within ± 0.50 D and 90% were within ± 1.00 D of the intended refraction. No significant change was observed in IOP ( p = 0.73). Although mild yet statistically significant reductions in ACD and ECD were noted, the magnitude of these changes was small. NEI-VFQ-25 scores showed significant improvement across multiple subscales, including general vision, near activities, distance activities, mental health, and color vision (all p-values < 0.05). Eyecryl PIOL implantation was associated with safe and effective visual and refractive outcomes in highly myopic eyes and significant improvements in both objective visual performance and patient-reported vision-related quality of life.