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Kim, Hong, and Lee: Long-term Change in Corneal Endothelium After Iris-fixed Phakic Intraocular Lens Insertion
Original Article

J Korean Ophthalmol Soc 2009;50(5):677-683.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.5.677

Long-term Change in Corneal Endothelium After Iris-fixed Phakic Intraocular Lens Insertion

Sung Eun Kim, MD, Sa Min Hong, MD, Hyung Keun Lee, MD

The Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, Seoul, Korea

Address reprint requests to Hyung Keun Lee, MD Department of Opthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine #146-92 Dogok-dong, Gangnam-gu, Seoul 135-720, Korea Tel: 82-2-2019-3440, Fax: 82-2-3463-1049, E-mail: shadik@yuhs.ac

Received 7 May 2008       Accepted 10 February 2009

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 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.

Methods

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.

Results

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 (p=0.445). There was no statistically significant change in pleomorphism and polymegathism of the endothelial cells after the surgery. There was no statistically significant correlation between endothelial cell loss and anterior chamber depth (r2=0.0488, p=0.377).

Conclusions

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.

Keywords: Corneal endothelial cell, Iris-claw phakic intraocular lens, Myopia

References

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Figure 1.
Changes in endothelial cell density (ECD).
jkos-50-677f1.tif
Figure 2.
Changes in coefficient of variation (CV) of endothelial cells.
jkos-50-677f2.tif
Figure 3.
Changes in frequency of hexagonal cells (6A).
jkos-50-677f3.tif
Figure 4.
Determination of correlation coefficient between anterior chamber depth and endothelial cell loss (pre-operative endothelial cell density [ECD]-postoperative ECD) per patient (n=31).
jkos-50-677f4.tif
Table 1.
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)
Table 2.
Changes in endothelial cell density (ECD)
Period Mean ECD (cells/mm2)±SD Mean observed Percentage ECD change p-value
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.

Table 3.
Changes in coefficient of variation (CV)
Period Mean CV (%)± SD Mean observed Percentage CV change P-value
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.

Table 4.
Changes in frequency of hexagonal cells (6A)
Period Mean 6A (%)± SD Mean observed Percentage 6A change P-value
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.

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