Iris-fixated phakic intraocular lens implantation to correct myopia and a predictive model of endothelial cell loss

J Cataract Refract Surg. 2015 Nov;41(11):2450-7. doi: 10.1016/j.jcrs.2015.05.030.

Abstract

Purpose: To report long-term results of Artisan phakic intraocular lens (pIOL) to correct myopia and to propose a model predicting endothelial cell loss after pIOL implantation.

Setting: Quinze-Vingts National Ophthalmology Hospital, Paris, France.

Design: Retrospective, interventional case series.

Methods: Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and central endothelial cell count (ECC) were determined before and at yearly intervals up to 5 years after pIOL implantation. Linear model analysis was performed to present a model that describes endothelial cell loss as a linear decrease and an additional decrease depending on postoperative loss.

Results: A total of 49 patients (68 eyes) implanted with pIOLs from January 2000 to January 2009 were evaluated. The mean preoperative and final spherical equivalent (SE) were -13 ± 4.10 and -0.75 ± 0.74 diopters (D), respectively. The mean preoperative and final central ECC were 2629 ± 366 and 2250 ± 454 cells/mm(2), respectively. There were no intraoperative complications for any of the eyes. One eye required surgery for repositioning the pIOL, and 1 eye required pIOL exchange for postoperative refractive error. The model predicted that for patients with preoperative ECC of 3000, 2500, and 2000 cells/mm(2), a critical ECC of 1500 cells/mm(2) will be reached at 39, 28, and 15 years after implantation, respectively.

Conclusions: Implantation of the pIOL was an effective and stable procedure after 5 years of follow-up. The presented model predicted EC loss after pIOL implantation, which can assist ophthalmologists in patient selection and follow-up.

Financial disclosure: The authors report no conflict of interest.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cell Count
  • Corneal Endothelial Cell Loss / diagnosis*
  • Endothelium, Corneal / pathology
  • Female
  • Humans
  • Iris / surgery*
  • Lens Implantation, Intraocular / methods*
  • Male
  • Middle Aged
  • Models, Theoretical
  • Myopia / surgery*
  • Phakic Intraocular Lenses*
  • Retrospective Studies
  • Visual Acuity / physiology
  • Young Adult