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E. Y. Oregon Miranda, J. J. Valadez, M. F. Dominguez Velasco, R. Naranjo Tackman; Endothelial Cell Count Before and a Year After Artisan Phakic Intraocular Lens Implantation, Comparison With Icl, in a Teaching Hospital Setting. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6118.
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To compare the endothelial cell count before and one year after implantation of Artisan and ICL phakic intraocular lens in a teaching hospital setting. To analyze the outcomes of this procedure comparing the anterior chamber depth, BCVA (best corrected visual acuity), IOP (intraocular pressure) and CV (coefficient of variance).
retrospective, descriptive, observational study. We selected 20 patients (40 eyes) with artisan phakic intraocular lens and 20 with ICL, which had basal endothelial cell count and one year after implantation. We recorded BCVA, IOP and CV along with anterior chamber depth with Orbscan II and compared the results between both groups of patients
we found endothelial cell count drop among the artisan implanted patients with a range of 8-50%, much more than the normal cell drop associated with aging per year (6%). Compared to ICL , endothelial cell drop was almost twice on artisan implanted patients. The frequency of complications was also higher on the Artisan implanted patients (18.9%). 3 out of 7 patients with complications had an anterior chamber depth narrower than 3 mm (42%). In spite of this, 92.9% of patients ended with a BCVA better than 20/60 a year after follow up. The coefficient of variance ranged between 10-80 higher than the basal measure on 51.35% of patients with Artisan.
there was a tendency towards more complications and endothelial cell count drop with implantation of iris claw phakic lenses (artisan) than ICL; perhaps this is related with chronic iritis and the damage produced by inflammatory agents. Narrow anterior chamber depth could be associated with the high incidence of complications.Also the surgical technique could play a role. Given the long term deleterious effects of endothelial cell loss, we suggest that there must be a realiable and rigid criteria for patient selection for this phakic intraocular lenses, and further study about it's safety and outcomes are required.
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