Evaluation of the inflammatory response after implantation of different types of phakic intraocular lenses in high myopia

High myopia is one of the main causes of reversible vision loss worldwide among the working-age population. Despite the widespread use of phakic intraocular lenses (PIOLs) for correction, immunological changes in the aqueous humor before and after implantation remain insufficiently studied. Objective. The study aimed to assess and compare cytokine levels in the aqueous humor before and after implantation of collamer-based and acrylic-based PIOLs in patients with high myopia. Material and methods. The study included 58 patients (103 eyes) with high myopia scheduled for PIOL implantation. The main group (A) consisted of 36 patients (68 eyes) who received collamer-based PIOLs. The comparison group (B) comprised 22 patients (35 eyes) who received acrylic-based PIOLs. The control group included 20 patients (20 eyes) with emmetropia. Cytokine levels of IL-6, TNF-α, and TGF-β2 were studied only in 18 patients (30 eyes) using solid-phase enzyme-linked immunosorbent assay with special reagents. Results. After implantation of different types of PIOLs, all patients included in the study achieved the desired outcome: residual refractive error (0.75±0.5 D) and visual acuity (0.85±0.17) remained stable during the 24-month postoperative period. Before PIOL implantation, patients with high myopia showed a statistically significant increase in IL-6 concentration — more than 2.5-fold (9.51±0.52 pg/ml vs 3.82±0.26 pg/ml in the control group) (p<0.001). The TNF-α level increased almost 1.8-fold (9.98±0.53 pg/ml vs 5.63±0.42 pg/ml in the control group) (p<0.001). In the main group, the TGF-β2 level was 15.99±1.09 pg/ml, which was 4.1- times higher than the control values (3.88±0.26 pg/ml) (p<0.001). Conclusion. PIOL implantation in high myopia is an effective, safe, and reliable correction method associated with marked changes in the local cytokine profile. Collamer lenses induce a less intense inflammatory response and a more active remodeling reaction compared with acrylic lenses.