Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report

Dong Wan Kang; Young Sub Eom; Jay Won Rhim; Su Yeon Kang; Hyo Myung Kim; Jong Suk Song

doi:10.7469/JKOS.2015.56.05.784

Journal List > J Korean Ophthalmol Soc > v.56(5) > 1010284

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Kang, Eom, Rhim, Kang, Kim, and Song: Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report

Original Article

J Korean Ophthalmol Soc 2015;56(5):784-788.

Published online: 7 September 2015

DOI: https://doi.org/10.7469/JKOS.2015.56.05.784

Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report

Dong Wan Kang, MD, Young Sub Eom, MD, Jay Won Rhim, MD, Su Yeon Kang, MD, Hyo Myung Kim, MD, PhD, Jong Suk Song, MD, PhD

Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea

￭ Address reprint requests to Jong Suk Song, MD, PhD Department of Ophthalmology, Korea University Guro Hospital, #148 Gurodong-ro, Guro-gu, Seoul 152-703, Korea Tel: 82-2-2626-3178, Fax: 82-2-2626-1261 E-mail: crisim@korea.ac.kr

Received 28 November 20148 January 2015 Accepted 1 April 2015

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.

초록

Purpose:

To report a case of decreased endothelial cell density 7 years after posterior chamber phakic intraocular lens implantation.

Case summary:

A 45-year-old man with high myopia combined with astigmatism was treated with Toric implantable Collamer Lens (ICL) implantation. The patient’s best corrected visual acuity was 0.7 in both eyes before the operation. After the treatment, his uncorrected visual acuity was 0.9 and corrected visual acuity was 1.0 in both eyes, indicating an improvement in visual function. Preoperative endothelial cell density measured 3,063 cells/mm² in the right eye and 3,126 cells/mm² in the left eye. At 5 years postoperatively, measurements were 2,897 cells/mm² in the right eye and 2,974 cells/mm² in the left, showing little change. However, a 6-year postoperative measurement of 2,198 cells/mm² in the right eye and 2,803 cells/mm² in the left showed a slight decrease in endothelial cell density in the right eye, and a follow-up measurement one year later displayed a rapid decline to 1,272 cells/mm² in the right eye and 2,852 cells/mm² in the left eye. The Toric ICL lens was removed from the right eye and phacoemulsification and posterior chamber intraocular lens implantation was performed. Two-month postoperative endothelial cell density was 1,257 cells/mm² and endothelial cell damage from the operation itself was minimal.

Conclusions:

ICL implantation may cause complications related to corneal endothelial cells as well as glaucoma. Patients should receive regular follow-up examinations for endothelial cell density.

Keywords: Endothelial cell loss, ICL implantation, Implantable contact lens

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Figure 1.

Corneal endothelial cell density of the right eye. (A) Before ICL implantation operation. (B) Seven years after ICL implantation operation. R = right; T = thickness; N = number; SD = standard deviation; CV = coefficient of variation; CD = cell density; ICL = implantable contact lens.

Figure 2.

Changes in corneal endothelial cell density. OD = oculus dexter (the right eye); OS = oculus sinister (the left eye).

Table 1.

Changes in corneal endothelial cell density (CD, cells/mm )

Follow-up	OD		OS		Remark
Follow-up	CD	% of loss	CD	% of loss	Remark
Preop	3,868		3,508
Postop 1 month	3,438	11.12	3,662	-4.39	ICL implantation
Postop 3 months	2,748	28.96	2,824	19.50
Postop 9 months	2,488	35.68	3,501	0.20
Postop 1 year	3,114	19.49	2,988	14.82
Postop 2 years	2,514	35.01	3,472	1.03
Postop 3 years	2,795	27.74	2,888	17.67
Postop 4 years	2,897	25.10	2,974	15.22
Postop 6 years	2,198	43.17	2,803	20.10
Postop 7 years 4 months	1,272	67.11	2,852	18.70	ICL removal
Postop 7 years 6 months	1,257	67.50

OD = oculus dexter (the right eye); OS = oculus sinister (the left eye); Preop = preoperation; Postop = postoperation; ICL = implantable contact lens.

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