Dependency of endothelial cell loss on anterior chamber depth within first 4 years after implantation of iris-supported phakic intraocular lenses to treat high myopia

• Published in: Journal of cataract and refractive surgery Vol. 42; no. 11; pp. 1562 - 1569
• Main Authors: Shajari, Mehdi, MD, Scheffel, Magdalena, MD, Koss, Michael Janusz, MD, PhD, FEBO, Kohnen, Thomas, MD, PhD, FEBO
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2016
• Subjects: Anterior Chamber; Cell Count; Cohort Studies; Endothelial Cells; Follow-Up Studies; Germany; Humans; Iris; Lens Implantation, Intraocular; Myopia - therapy; Ophthalmology; Phakic Intraocular Lenses; Retrospective Studies
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2016.08.027

Purpose To evaluate the effect of the anterior chamber depth (ACD) on the central corneal endothelial cell density (ECD) in eyes after implantation of an iris-fixated phakic intraocular lens (pIOL). Setting Department of Ophthalmology, Goethe-University, Frankfurt, Germany. Design Retrospective nonrandomized case series. Methods An Artisan pIOL was implanted in eyes of highly myopic patients. Follow-up examinations at 1, 12, 24, 36, and 48 months included evaluation of ECD and adverse events. Three cohorts based on the ACD were established and their ECDs compared. All eyes had 1-year and 4-year postoperative ECD measurements available. Statistical analysis included linear regression analysis to evaluate the influence of ACD on ECD. Results The study comprised 95 eyes (52 patients). Four years after surgery the mean spherical equivalent changed from −11.06 diopters (D) ± 4.77 (SD) to −0.42 ± 0.47 D. Severe adverse events were not detected. There was a significantly higher ECD loss after 4 years in patients with an ACD of less than 3.00 mm than in those with an ACD greater than 3.40 mm (−224 cells/mm2 ) ( P  < .01). There was no significant difference in ECD between eyes with an ACD of 3.00 to 3.39 mm and eyes with an ACD less than 3.00 mm ( P  = .23) or more than 3.40 mm ( P  = .08). Conclusions The iris-claw pIOL precisely and safely corrected high myopia. However, the loss in ECD can be considerable. Establishing stricter exclusion criteria for ACD might reduce this loss. Financial Disclosure Proprietary or commercial disclosures are listed after the references.