: To evaluate anterior segment optical coherence tomography (AS-OCT) in preoperative simulation of postoperative iris-fixated phakic intraocular lens (pIOL) position in anterior chamber

: In this prospective interventional case series, 26 eyes of 16 patients were examined. Using AS-OCT the position of pIOL was simulated preoperatively in two ways and compared with postoperative actual pIOL position. For preoperative evaluations, first the simulator was placed on the posterior pigmented epithelium of the iris. Then the simulation was done with the simulator placed in the middle of iris tissue. The following distances were measured: the distance from the center of the pIOL to the endothelium, the distance from the edge of the pIOL to the endothelium and the distance from the posterior surface of pIOL to the crystalline lens

Although all distances in both simulation methods (except the lens vault in first method of simulation) were highly correlated (P< .009 for all) only the results of simulation with the simulator placed in the middle of iris tissue were not statistically different from the corresponding postoperative measurements (P=.209 and P=.564 for the distance from endothelium to the center and edge of pIOL, respectively).

Using pIOL template of AS- OCT for preoperative simulation of iris-fixated pIOLs improves the criteria of patient selection for implantation of these PIols. We propose that the simulator should be placed in the middle of iris tissue for preoperative simulation.