SAFETY OF IRIS CLAW PHAKIC INTRAOCULAR LENSES: AN ENDOTHELIAL MICROSCOPY LONG TERM STUDY

Abstract

Abstract: : Purpose: To describe the long term evolution of the endothelial cells density after implanting two different models of iris claw phakic intraocular lenses. Methods: Retrospective review of 110 eyes having received an iris claw (Artisan, Ophtec TM) phakic intraocular lens between 1998 and 2002 to correct myopia (15) and hyperopia (95). The mean follow–up was 20.78 ± 30 months (range 6–60 months). Anterior chamber depth, minimal optic–endothelium distance (microns) and angle of anterior chamber (degrees) were measured by Ultrasonic Biomicroscopy in 10 myopic and hyperopic cases. Results: The endothelium of Artisan lenses to correct hyperopia suffered a 28.78% decrease in the number of cells along the 5 years of follow–up (t–test, p<0.001). The iris–claw lenses inserted to correct myopia had a decrease in endothelial cell population of 18.22 in the first year after surgery and 9.1% per year in the following 2 years (t–test, p<0.001). Peripherally shallow anterior chamber seems to be a decisive factors in endothelial cells loss in iris claw lenses correcting hyperopia. Conclusions: A progressive decrease in endothelial cell population was found in both types of phakic lenses. A careful long term follow–up is mandatory in these types of lenses.

Keywords: refractive surgery: phakic IOL • cornea: endothelium