Abstract
Purpose: :
Phakic anterior chamber IOL for the correction of high ammetropia have a potentially negative influence on corneal endothelium cell density. The implantation procedure may cause an immediate loss in cells, further endothelial cell loss can be observed over time. Patients are advised to have yearly follow-up exams including specular microscopy. The purpose of our study was to quantitatively evaluate the long-term effect of silicone iris-fixated IOL on endothelial cell density.
Methods: :
32 eyes of 17 patients (8 male/9 female, mean age 44) were implanted with a phakic foldable iris-fixated intraocular lens for the correction of high myopia (mean -8.53dpt, min -4.5/max -12.8). Specular microscopy was performed preoperatively, in the early postoperative period and with a mean long-term follow-up of 6,8 years. Clinical evaluation included anterior and posterior segment examination.
Results: :
Preoperative cell density was 2856 (SD 269). Surgery was uneventful in all cases, all patients were operated upon by the same experienced surgeon (HBD). Postoperative cell density after 3 months was 2789 (SD 252). No major postoperative complications were noted, however 34% showed pigmented precipitates on the implant 5-6 months after implantation. Long-term follow up revealed mean cell density of 2519 at a mean follow-up time of 6,8 years, equalling a loss of 11,8% over 5-7 years. Hexagonality was found in 54.5% after the follow-up period. We did not find a significant correlation of cell loss with age. There was no correlation between cell loss and initial refraction or gender. When both eyes had the implant, the development was comparable between right and left side.
Conclusions: :
Our data indicate that Veriflex® foldable iris-claw IOL are associated with an excellent stability of the endothelial cell density over a longer period. As our patient cohort was homogeneous concerning their age, any possible effect of cell loss due to age at implantation could not be demonstrated. Individual cases with up to 20% of cell loss after the first quarter underline the necessity of continued endothelial cell density measurements over the lifetime of the patient with the lens. Our study spans the longest follow-up period reported so far for Veriflex® IOL.
Keywords: cornea: endothelium