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Choi, Choi, and Her: Two-year Endothalial Changes after Iris Fixed Phakic Intraocular Lens Implantation in Korean
Original Article

J Korean Ophthalmol Soc 2008;49(2):230-237.

Published online: 31 August 2008

DOI: https://doi.org/10.3341/jkos.2008.49.2.230

Two-year Endothalial Changes after Iris Fixed Phakic Intraocular Lens Implantation in Korean

Woo Seok Choi, M.D.1, Bong Joon Choi, M.D.2, Jun Her, M.D.1

1Department of Ophthalmology, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea

2Lee Eye Clinic, Pusan, Korea

Address reprint requests to Bong Joon Choi, M.D. Lee Eye Clinic #1124-11 Yeonsan-5dong, Yeonje-gu, Pusan 611-080, Koera Tel: 82-51-866-7592, Fax: 82-51-866-7595, E-mail: Eyebong1@hanmail.net

Received 12 April 2007       Accepted 2 October 2007

Copyright © 2008 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate quantitative and morphometric endothelial changes in phakic eyes implanted with an iris-fixed phakic intraocular lens in Korean patients.

Methods

We prospectively examined the endothelial cell density (ECD), ECD loss (ECL), coefficient variations (CV), and frequency of Hexagons (6A) in 46 phakic eyes implanted with an iris-fixed phakic intraocular lens. The effect of anterior chamber depth (ACD) and diopter of iris-fixed phakic intraocular lens on ECD was statistically analyzed.

Results

Preoperative mean ECD was 2923±257 cells/mm2. ECL at postoperative 1, 3, 6, 12, and 24 monthswas 0.71%, 0.88%, 0.70%, 0.64%, and 2.34%. It was significant only in the month 24 results. The mean CV value at the same time was 0.343, 0.342, 0.334, 0.329, 0.326, and 0.338. The change was significant at the 12th month. The mean 6A value at the same time was 58.2%, 57.8%, 59.7%, 59.6%, 60.1%, and 58.8%. There was no significant change in 6A value. Preoperative ACD and diopter of iris-fixed phakic intraocular lens didn't affect the ECD change.

Conclusions

This two-year follow-up study of changes in endothelial cells after implantation iris-fixated phakic intraocular lens showed statistically significant decreases in the cells, which is not very significant considering the physiologic reduction rate of the cells. Thses decreases showed a tendency to be stabilized with recovery of morphological changes. Further long-term follow-up is needed to determine its long-lasting effect.

Keywords: Endothelial cell density, Iris fixed phakic intraocular lens, Morphometric change

References

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Figure 1.
Diagram of the 6-mm Artisan lens (Ophtec BV, Groningen, Netherlands) with relevant dimensions. The haptics lie in the pupillary planes, whereas the optic vaults anterior to the pupil to prevent iris chafing.
jkos-49-230f1.tif
Figure 2.
Critical distance (S). At least, more than 1 mmis recommended for preventing iris rubbing or IOL movement.
jkos-49-230f2.tif
Figure 3.
Center method in calculating endothelial cell density. After 100 cell dotting, endothelial cell density is calculated automatically.
jkos-49-230f3.tif
Figure 4.
Endothelial cell density changes at two-year follow-up.
jkos-49-230f4.tif
Figure 5.
Morphologic changes in coefficient variation (CV) and frequency (6A) of hexagons (%) at two-year follow-up.
jkos-49-230f5.tif
Figure 6.
Scatter plot showing the relationship between anterior chamber depth (ACD) and endothelial cell density chage (ECD change) after 24months and between diopter of intraocular lens (IOL) and endothelial cell density change (ECD change) after 24 months.
jkos-49-230f6.tif
Table 1.
Patient characteristics
Measurement (n=46) Mean±SD Range
Coefficient variation (%) 34.32±3.95 26.0∼46.0
Hexagonal frequency (%) 58.22±8.66 30.7∼66.8
ACD (mm) 3.77±0.21 3.20∼4.16
IOL power (D) −11.18±3.81 −5.0∼-22.0
Critical Distance (mm) 1.72±0.17 1.13∼2.02

ACD=anterior chamber depth; IOL=intraocular lens; D=diopters; SD=standard deviation.

Table 2.
Endothelial cell density (ECD) changes
  ECD Changes from Baseline (%) P-value
Pre-operation 2923±257    
1st month 2885±312 −0.71 0.453
3rd month 2888±260 −0.88 0.320
6th month 2908±275 −0.70 0.239
12th month 2921±296 −0.64 0.474
24th month 2854±254 −2.34 0.004*

* P<0.05.

Table 3.
Morphologic changes of endothelial cells; Coefficient variation (CV) in cell area
  CV Changes from Baseline (%) P-value
1st month 0.342±0.034 0.11 0.945
3rd month 0.334±0.032 −0.33 0.880
6th month 0.329±0.040 −3.83 0.091
12th month 0.326±0.031 −4.94 0.005*
24th month 0.338±0.043 −1.58 0.453

* P<0.05.

Table 4.
Morphologic changes of endothelial cells; Frequency of hexagons (6A)
  6A (%) Changes from Baseline (%) P-value
1st month 57.8±7.8 −0.7 0.647
3rd month 59.7±9.2 +2.26 0.330
6th month 59.6±8.1 +1.97 0.336
12th month 60.1±6.6 +0.91 0.663
24th month 58.8±8.1 +0.93 0.600
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