Influence of anterior chamber morphometrics on endothelial cell changes after phakic intraocular lens implantation
Accepted 20 August 2008.
Purpose
To analyze the position of iris-fixated phakic intraocular lenses (pIOLs) using anterior segment optical coherence tomography (AS-OCT) and evaluate the effect of anterior chamber morphometrics on endothelial cell changes.
Setting
Department of Ophthalmology, Academic Hospital Maastricht, The Netherlands.
Methods
In this cross-sectional study, AS-OCT was used to measure the distances from the center and the edges of the pIOL to the corneal endothelium in 242 eyes with various models of myopic pIOLs. Endothelial cell measurements were performed preoperatively and at each follow-up examination.
Results
The mean follow-up was 34.1 months ± 24.7 (SD) (range 3 months to 7 years). The mean distance between the edge of the pIOL and the endothelium was 1.37 ± 0.22 mm. Although this distance was smaller than the safety value of 1.50 mm in 68.6% of the eyes, no eye developed corneal decompensation. There was a significant endothelial cell density (ECD) loss of 1.28% ± 8.46%, 3.25% ± 8.24%, and 5.02% ± 10.40% at 2 years, 5 years, and 7 years, respectively. Linear mixed-model analysis predicted a yearly ECD loss of 0.98% for a mean edge distance of 1.37 mm, 0.15% for an edge distance of 1.59 mm (mean plus 1 SD), and 1.80% for an edge distance of 1.15 mm (mean minus 1 SD).
Conclusions
A shorter distance between the edge of the pIOL and the endothelium was significantly associated with higher ECD loss. For safety reasons, the postoperative examination should include long-term evaluation of the anterior chamber morphometrics in addition to ECD counts.
From the Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands
Corresponding author: Rudy M.M.A. Nuijts, MD, PhD, Department of Ophthalmology, University Hospital Maastricht, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
No author has a financial or proprietary interest in any material or method mentioned
ABSTRACT