Long Term Corneal Endothelial Cell Density Loss after Iris-fixed Phakic Intraocular Lens Implantation

Jae Sung Park; Byung Gun Park; Bong Joon Choi; Jong Soo Lee

doi:10.3341/jkos.2017.58.4.473

Journal List > J Korean Ophthalmol Soc > v.58(4) > 1010751

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Park, Park, Choi, and Lee: Long Term Corneal Endothelial Cell Density Loss after Iris-fixed Phakic Intraocular Lens Implantation

Original Article

J Korean Ophthalmol Soc 2017;58(4):473-477.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.4.473

Long Term Corneal Endothelial Cell Density Loss after Iris-fixed Phakic Intraocular Lens Implantation

Jae Sung Park, M.D.¹, Byung Gun Park, M.D.², Bong Joon Choi, M.D.³, Jong Soo Lee, MD, PhD^2,

^¹Danggam Choi Eye Clinic, Busan, Korea

^²Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea

^³Lee Eye Clinic, Busan, Korea

Address reprint requests to Jong Soo Lee, MD, PhD Department of Ophthalmology, Pusan National University Hospital, #179 Gudeok-ro, Seo-gu, Busan 49241, Korea Tel: 82-51-240-7321, Fax: 82-51-242-7341 E-mail: jongsool@pusan.ac.kr

The work was supported by a 2- year research grant of Pusan national University.

Received 13 October 20161 February 2017 Accepted 21 March 2017

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 report three cases of severe endothelial cell density loss after iris claw phakic intraocular lens (Artisan^® lens) implantation.

Case summary

A 32-year-old woman underwent iris claw intraocular lens implantation in both eyes. Preoperative corneal endo-thelial cell count was 2,556 cells/mm² in the right eye and 2,674 cells/mm² in the left eye. After 4 years, the corneal endothelial cell count was 1,968 cells/mm² in the right eye and 1,997 cells/mm² in the left eye. A 27-year-old woman underwent iris claw in-traocular lens implantation in both eyes. Preoperative corneal endothelial cell count was 3,222 cells/mm² in the right eye and 3,122 cells/mm² in the left eye. After 4 years 8 months, the corneal endothelial cell count was 2,729 cells/mm² in the right eye and 2,488 cells/mm² in the left eye. A 39-year-old woman underwent phakic intraocular lens implantation in other clinic, and the lens of left eye was removed the same day because of elevated intraocular pressure. She underwent iris claw intraocular lens im-plantation in the left eye. Preoperative corneal endothelial cell count was 2,500 cells/mm² in the left eye, which decreased to 1,873 cells/mm² after 8 years. Six months after intraocular lens removal and cataract surgery, her cornea endothelial cell count was 1,412 cells/mm².

Conclusions

Although iris-fixed intraocular lens implantation is safe and effective for correcting myopia, at least 4 years of long-term observation for evaluating corneal endothelial cell density maybe necessary.

Keywords: Artisan, Endothelial cell density, Iris-fixed phakic intraocular lens

References

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Figure 1.

A 27-year-old woman underwent Artisan^Ⓡ lens implantation with superior corneal incision, sutured by 10-0 nylon. (A) Right eye. (B) Left eye.

Figure 2.

A 27-year-old woman who underwent Artisan^Ⓡ lens implantation showed the distance between the lens and the corneal endo-thelium measured by Scheimpflug imaging. (A) Right eye. (B) Left eye.

Table 1.

The change of corneal endothelial cell density after Artisan® lens implantation.

		Endothelial cell density (cells/mm²)
		Preoperative	4 years (decrease amount, %)	8 years (decrease amount, %)
Case 1	OD	2,556	1,968 (23.00)	NA
	OS	2,674	1,997 (25.32)	NA
Case 2	OD	3,222	2,729 (15.30)	2,298 (28.68)
	OS	3,122	2,488 (20.31)	2,154 (31.01)
Case 3	OS	2,500	2,137 (14.52)	1,873 (25.08)
Average		2,814.8	2,263.8 (19.58)	2,108.3 (28.48)

Values are presented as n (%).

NA = non available.

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