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Nicolas Lecuen, Otmane Sandali, Elena Basli, Barbara Ameline-Chalumeau, Vincent Borderie, Laurent Laroche; Iris-fixated Phakic Intraocular Lens For High Ametropia Results. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5778.
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The aim of this study is to evaluate refractive outcomes and variation of endothelial cell density after implantation of iris-fixated intraocular lens in phakic eyes.
Retrospective, non randomized study of patient who underwent surgery between January,2000 and December,2009 in the same department in the Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts. Outcomes measures were best-spectacle corrected visual acuity, uncorrected visual acuity, spherical equivalent, endothelial cell density and postoperative complications.
This study consisted of sixty phakic eyes of 34 patients including 52 myopic eyes and 8 hyperopic eyes. Fifty five Verisyse/Artisan and 5 foldable Artiflex were implanted. Five eyes underwent further keratorefractive surgery (Bioptic). The mean follow-up was 68 months. The mean preoperative best spectacle-corrected visual acuity was 0.17 logMAR. The mean postoperative uncorrected visual acuity was 0.32 logMAR and the mean postoperative best spectacle-corrected visual acuity was 0.13 logMAR. In the myopic group, the mean preoperative and postoperative spherical equivalent was -13.5D and -1.5D. In the hyperopic group, preoperative and postoperative spherical equivalent was +6.75D and 0 D. The mean preoperative endothelial cell density was 2818 cells/mm². At one year postoperative, the mean endothelial cell density was 2455 cells/mm² (n=40). The mean postoperative endothelial cell density was 2131 cells/mm2, the mean change from baseline to 68 months was -24%. Expected endothelial cell density at the end of follow up when corrected for an expected natural loss of 0.6% per year was 2724 cells/mm². There were no endophthalmitis or glaucoma. Five eyes of 3 patients underwent explantation of the phakic intraocular lens combined with lensectomy. Two eyes presented an intraocular lens dislocation leading to a intraocular lens repositionning, one eye presented corneal decompensation leading to corneal graft.
Iris-fixated intraocular lens in phakic eyes is an efficient surgical alternative for correction of high ametropia. Potential complications such as progressive endothelial cell loss and risk of dislocation are major concerns in operative decision.Close follow-up with regular monitoring is necessary in patients with phakic intraocular lens.
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