To investigate long-term endothelial changes in phakic eyes implanted with iris-claw phakic intraocular lens (IOL) (Artisan® lens Ophtec, Groningen, Netherlands) and to identify the associated factors.
Thirty-one eyes of 18 patients underwent Artisan phakic IOL implantation and were followed up for over 1 year. The authors retrospectively examined the endothelial cell density, percentage of hexagonal cells and coefficient of variation using the result of non-contact specular microscope.
The mean endothelial cell loss was 0.9% at 23.9±9.44 months of the mean follow-up period. There was no statistically significant decrease in endothelial cell density (
No clinically significant endothelial damage occurred after iris-claw phakic IOL implantation. However, special attention should be given to patients with shallow anterior chamber depth for iris-claw phakic IOL insertion to avoid unintended endothelial damage and long-term endothelial checkups using a specular microscope are critical for long-term protection of endothelial cells.
Changes in endothelial cell density (ECD).
Changes in coefficient of variation (CV) of endothelial cells.
Changes in frequency of hexagonal cells (6A).
Determination of correlation coefficient between anterior chamber depth and endothelial cell loss (pre-operative endothelial cell density [ECD]-postoperative ECD) per patient (n=31).
Population data and baseline characteristics
Characteristics | Mean± SD (range) |
---|---|
Number of patients (eyes) | 18 (31) |
Gender (M:F) | 5: 13 |
Age (yrs) | 29.5±8.2 (20∼50) |
Duration (months) | 23.9±9.44 (12∼43) |
Mean spherical refractive error (diopters) | −9.81±4.14 (−4.00∼-17.75) |
Anterior chamber depth (mm) | 3.67±0.31 (3.06∼4.29) |
Central corneal thickness (μm) | 538.7±37.0 (462∼596) |
Implanted IOL power (diopters) | −10.29±3.78 (−4.0∼-16.5) |
Changes in endothelial cell density (ECD)
Period | Mean ECD (cells/mm2)±SD | Mean observed Percentage ECD change | |
---|---|---|---|
Preoperative | 2785±336 | NA |
NA |
1 month | 2767±314 | +0.92 | 0.962 |
6 months | 2654±351 | −5.20 | 0.020 |
12 months | 2656±405 | −2.84 | 0.346 |
18 months | 2746±248 | −2.33 | 0.335 |
24 months | 2898±341 | −3.40 | 0.309 |
30 months | 2524±457 | −9.01 | 0.042 |
36 months | 2581±253 | +11.40 | 0.109 |
42 months | 2390±203 | −2.84 | 0.687 |
NA=not applicable.
Changes in coefficient of variation (CV)
Period | Mean CV (%)± SD | Mean observed Percentage CV change | |
---|---|---|---|
Preoperative | 37.2±5.2 | NA |
NA |
1 month | 33.0±8.1 | +11.5 | 0.022 |
6 months | 37.6±9.0 | −5.9 | 0.566 |
12 months | 37.3±6.9 | +0.73 | 0.783 |
18 months | 31.4±6.7 | +14.2 | 0.047 |
24 months | 33.9±7.8 | +16.7 | 0.088 |
30 months | 35.8±8.0 | −2.0 | 0.917 |
36 months | 35.3±5.0 | +1.87 | 0.823 |
42 months | 34.7±3.8 | +7.91 | 0.403 |
NA=not applicable.
Changes in frequency of hexagonal cells (6A)
Period | Mean 6A (%)± SD | Mean observed Percentage 6A change | |
---|---|---|---|
Preoperative | 56.6±10.7 | NA |
NA |
1 month | 56.4±10.9 | −0.7 | 0.570 |
6 months | 55.3±9.0 | +2.3 | 0.718 |
12 months | 54.0±6.3 | +0.6 | 0.652 |
18 months | 59.3±16.4 | +8.2 | 0.607 |
24 months | 56.4±12.0 | +4.3 | 0.589 |
30 months | 60.3±11.8 | +7.5 | 0.883 |
36 months | 47.7±3.2 | −4.9 | 0.613 |
42 months | 48.0±5.3 | −6.3 | 0.605 |
NA=not applicable.