June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Preoperative simulation of iris-fixated phakic intraocular lenses (IF-pIOLs) does not add a significant benefit in the prediction of endothelial cell (EC) loss in myopic eyes.
Author Affiliations & Notes
  • Soraya M.R. Jonker
    Ophthalmology, University Eye Clinic Maastricht, Maastricht, Netherlands
  • Tos TJM Berendschot
    Ophthalmology, University Eye Clinic Maastricht, Maastricht, Netherlands
  • Annick A Ronden
    Ophthalmology, University Eye Clinic Maastricht, Maastricht, Netherlands
  • Isabelle EY Saelens
    Ophthalmology, University Eye Clinic Maastricht, Maastricht, Netherlands
  • Noël JC Bauer
    Ophthalmology, University Eye Clinic Maastricht, Maastricht, Netherlands
  • Rudy MMA Nuijts
    Ophthalmology, University Eye Clinic Maastricht, Maastricht, Netherlands
  • Footnotes
    Commercial Relationships   Soraya Jonker, None; Tos TJM Berendschot, None; Annick A Ronden, None; Isabelle EY Saelens, None; Noël JC Bauer, None; Rudy Nuijts, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5277. doi:
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      Soraya M.R. Jonker, Tos TJM Berendschot, Annick A Ronden, Isabelle EY Saelens, Noël JC Bauer, Rudy MMA Nuijts; Preoperative simulation of iris-fixated phakic intraocular lenses (IF-pIOLs) does not add a significant benefit in the prediction of endothelial cell (EC) loss in myopic eyes.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5277.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Although proof exists that a smaller distance from an IF-pIOL to the corneal endothelium results in increased EC-loss, no model incorporates preoperative IF-pIOL simulations to predict EC-loss before surgery. We performed a prospective, observational clinical study using preoperative EC density (ECD), anterior chamber depth (ACD), and the simulated central (sCD) and peripheral (sPD) distance from the IF-pIOL to the endothelium to compose a model that predicts EC-loss in myopic eyes implanted with IF-pIOLs.

Methods : 179 eyes of 95 patients that underwent preoperative IF-pIOL simulation followed by implantation of myopic (toric) IF-pIOLs at the University Eye Clinic Maastricht, between 2006 and June 2016, were included in the current analysis. Preoperative mean age was 38±12 years. Optical Coherence Tomography (OCT) was used to determine ACD, sCD and sPD, and specular microscopy to determine ECD. Specular microscopy measurements were repeated 3, 6 and 12 months postoperatively, followed by annual assessments. A mixed-model linear regression analysis was performed with eye identification number as a grouping variable and time, preop ECD, ACD, sCD, sPD and significant interactions with time as covariates.

Results : Multiple models were composed to assess the necessity of preoperative IF-pIOL simulation, because mean preoperative ACD (3.23±0.36mm), sCD (2.40±0.33mm) and sPD (1.90±0.29mm) were highly correlated (p<0.001). All models used preoperative ECD, time, covariate (ie. ACD, sCD or sPD), and interaction between time and covariate to predict ECD. Only interactions between time and ACD (p=0.002) or sCD (p=0.005) were significant predictors. Using the mean preoperative ECD of 2725.4 cells/mm2 and the mean ACD or sCD, both models reached a critical ECD of 1500 cells/mm2 after 21 years (range 15 to 32 years when using the mean±1SD ACD or sCD), with a predicted total 5-year EC-loss of -12% (range -15 to -9% when using the mean±1SD ACD or sCD).

Conclusions : The results of both models emphasize smaller anterior chamber dimensions as risk factors and predictors of higher EC-loss, and suggest IF-pIOL simulation does not add a significant benefit in predicting EC-loss in IF-pIOL implanted myopic eyes.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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