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Cho, Lee, and Kim: Corneal Endothelial Changes After ICL (Implantable Collamer Lens) Insertion
Original Article

J Korean Ophthalmol Soc 2009;50(2):189-194.

Published online: 3 January 2009

DOI: https://doi.org/10.3341/jkos.2009.50.2.189

Corneal Endothelial Changes After ICL (Implantable Collamer Lens) Insertion

Yang Kyeung Cho, MD, PhD1, Hyun Soo Lee, MD2, Man Soo Kim, MD, PhD2

1Department of Ophthalmology, The St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea

2Department of Ophthalmology, The KangNam St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Man Soo Kim, MD, PhD Department of Ophthalmology, Kangnam St. mary’s Hospital, The Catholic University College of Medicine #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-590-1523, Fax: 82-2-599-7405, E-mail: mskim@catholic.ac.kr

Received 23 January 2008       Accepted 2 September 2008

Copyright © 2009 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 evaluate the stability of corneal endothelial cells after ICL (implantable contact lens) implantation.

Methods

Retrospective review of 50 eyes were subjected to implantation of ICL by one surgeon from December 2003 to April 2008. During the follow-up period, the number of eyes with regular follow-up decreased and remained at 18 eyes at the time of a three-year follow-up. Patients were examined preoperatively and at one, three, and six months and one, two, and three years postoperatively. The main outcome measures were the change in corneal endothelial cell density (CD), coefficient of variation (CV), and hexagonality (HA). This analysis was done in all eyes and especially in the 18 eyes with regular follow-up for three years and 11 eyes with changes in CV and HA corresponding to the normal endothelial wound healing process for three years.

Results

Corneal endothelial CD, CV, and HA were not significantly changed compared with their preoperative values throughout the three-year follow-up period for all eyes. In the early postoperative period, there was a slight decrease in CD, but it increased after the second year of follow-up (range: -3.12%∼+2.84%); there was a slight increase in CV, but it decreased after the six-month follow-up (-6.63%∼+5.56%); and there was a slight decrease in HA, but it increased after the three-month follow-up (range: -0.88%∼10.64%). Similarly, there were no significant changes in corneal endothelial cell density in the 18 eyes with regular follow-up or the 11 eyes with changes in CV and HA corresponding to normal endothelial wound healing process for three years.

Conclusions

The results show stability of corneal endothelial cells after ICL implantation.

Keywords: Corneal endothelial cell, ICL (Implantable Collamer Lens)

References

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Figure 1.
Postoperative change of endothelial cell density, coefficient of variation and hexagonality in total eyes (total), 18 eyes with 3 year follow up (18 eyes), 18 eyes with changes of CV and HA corresponding to the normal wound healing process (11 eyes). There were no significant changes in cell density, coefficient of variation and hexagonality compared with preoperative value.
jkos-50-189f1.tif
Table 1.
Preoperative and postoperative refraction
Follow-Up (m*) N† Refraction (D‡, Mean± SD§)
preop 50 -11.37±4.97
Postop 1m 48 -0.31±1.42
Postop 3m 28 -1.08±1.80
Postop 6m 24 -0.77±1.76
Postop 12m 21 -2.20±2.36
Postop 24m 18 -1.54±1.53
Postop 36m 18 -1.24±1.13

* m=month;

† N=number;

‡ D=Diopter;

§ Mean±SD=spherica equivalent.

Table 2.
Postoperative changes of endothelial cell density (CD, cell/mm2), coefficient of variation (CV), hexagonality (HA, %) in all eyes for 3 years
Follow-Up (m*) N† CD [%‡] P value§ CV [%‡] P value§ HA [%‡] P value§
Preop 50 2831±277 34±6 55±11
Postop 1m 48 2733±351 [-3.12] P=0.061 35±5 [5.56] P=0.089 54±8 [-0.88] P=0.067
Postop 3m 28 2728±264 [-0.95] P=0.327 33±5 [4.69] P=0.782 57±9 [6.70] P=0.572
Postop 6m 24 2820±276 [-0.95] P=0.761 31±4 [-4.05] P=0.119 59±9 [9.80] P=0.377
Postop 12m 21 2708±283 [-2.23] P=0.181 32±5 [-5.12] P=0.116 55±13 [1.49] P=0.985
Postop 24m 18 2732±226 [2.84] P=0.266 33±5 [-2.81] P=0.265 57±9 [6.73] P=0.722
Postop 36m 18 2703±269 [1.54] P=0.231 32±6 [-6.63] P=0.070 59±7 [10.64] P=0.069

* m=month;

† N=number;

‡ [%]=% of postoperative change compared with preoperative value;

§ P value=Wilcoxon signed ranks test, compared between preoperative and postoperative values at a specified time point.

Table 3.
Postoperative changes of endothelial cell density (CD, cell/mm2), coefficient of variation (CV), hexagonality (HA, %) in 18 eyes with regular follow-up for 3 years
Follow-Up (m*) N † CD [%‡] P value§ CV [%‡] P value§ HA [%‡] P value§
Preop 18 2667±230 36±7 55±10
Postop 1 m 18 2589±225 [-2.58] P=0.286 38±5 [8.17] P=0.103 52±8 [-3.90] P=0.067
Postop 3 m 13 2705±280 [1.09] P=0.861 33±5 [-1.81] P=0.649 56±8 [1.89] P=0.646
Postop 6 m 12 2757±257 [3.76] P=0.182 33±3 [3.27] P=0.906 56±8 [-1.27] P=0.533
Postop 12 m 14 2644±302 [-1.91] P=0.397 33±5 [-4.30] P=0.206 55±12 [0.36] P=0.780
Postop 24 m 18 2732±226 [2.80] P=0.266 33±5 [-2.81] P=0.265 57±9 [6.73] P=0.722
Postop 36 m 18 2703±269 [1.54] P=0.231 32±6 [-6.63] P=0.070 59±7 [10.64] P=0.069

* m=month;

† N=number;

‡ [%]=% of postoperative change compared with preoperative value;

§ P value=Wilcoxon signed ranks test, compared between preoperative and postoperative values at a specified time point.

Table 4.
Postoperative changes of endothelial cell density (CD, cell/mm2) in eyes that show changes of coefficient of variation (CV) and hexagonality (HA, %) corresponding to normal endothelial wound healing process for 3 years
Follow-up (m*) N† CD [%‡] P value§
Preop 11 2685±230
Postop 1m 11 2640±214 [-1.43] P=0.722
Postop 3m 9 2748±257 [1.70] P=0.515
Postop 6m 10 2791±237 [3.85] P=0.203
Postop 12m 9 2644±368 [-3.18] P=0.374
Postop 24m 11 2716±236 [1.62] P=0.878
Postop 36m 11 2674±310 [0.24] P=0.790

* m=month;

† N=number;

‡ [%]=% of postoperative change compared with preoperative value;

§ P value=Wilcoxon signed ranks test, compared between preoperative and post-operative values at a specified time point.

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