AIM: To evaluate the safety, efficacy and stability of posterior chamber phakic intraocular lens(ICL)implanation and clear lens extraction for the correction of high myopia.

METHODS: The study enrolled 56 cases(100 eyes)of high myopia. Group I comprised 32 cases(58 eyes)receiving ICL implantation and Group II comprised 24 cases(42 eyes)undergoing clear lens extraction. In this study, we evaluated the two groups of subject's the visual and refractive results, intraocular pressure(IOP), endothelial cell density(ECD), anterior chamber depth(ACD), lens transparency, the surgical complications as well as visual adverse symptoms before and after surgery.

RESULTS: The postoperative subjects in group I and group II were followed, uncorrected vision acuity(UCVA)>0.5 were 69.0% in group I and 71.4% in group II after 3mo. UCVA>0.5 were 72.4% in group I and 73.8% in group II after 1a. Predictability of the manifest spherical equivalent refraction within ±1.00D was achieved in 62.1% of eyes in group I and 57.1% in group II after 1a. The central vault of the ICL(distance from posterior surface of ICL to the crystalline lens)measured with anterior segment optical coherence tomography(AS-OCT)was 0.35-0.54(0.40±0.16)mm. Twelve point one percent of eyes in group I and 7.1% of eyes in group II had transient mild increase in IOP. Here were statistically significant differences between preoperative and postoperative ECD(P<0.001). Complications of surgery: 1 eye had ICL spontaneous rotation, 2 eyes had anterior subcapsular cataract, 4 eyes noticed halos around lights at night in group I. Three eyes had posterior capsule mild opacification, 3 eyes noticed halos around lights at night, 12 eyes had difficulty in near vision in group II.

CONCLUSION: ICL implantation and clear lens extraction are effective, safe and predictable surgical option for the management of high myopia. No severe complications occurred, but its long time effect and safety still need more time to prove.