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Comparison of two surgical techniques for iris-fixated phakic intraocular lenses explantation in term of endothelial consequences

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First Author: R.Guillon-Rolf FRANCE

Co Author(s):    R. Guillon-Rolf   C. Sculo   A. Bayle   V. Borderie   B. Ameline        

Abstract Details

Purpose:

Iris-fixated lens to correct high myopia can induce endothelial cell loss and therefore need to be removed. We wanted to compare two surgical techniques of removal. We undertook specular microscopy and a range of associated refractive results.

Setting:

Retrospective cohort study, at Centre Hospitalier National des Quinze-Vingt, Paris, France from 2012 to 2019.

Methods:

Thirty-five patients were screened and 9 patients (14 eyes) were included in the study. The inclusion criteria were the presence of specular microscopy preoperatively in the 5 quadrants of the cornea and one year after surgery. Surgery was to be done without clinically visible endothelial decompensation or planned corneal transplantation. Seven eyes had the whole lens explantation technique (group 1), seven eyes had the second technique with the section of the lens in two parts (group 2). The main outcome was the endothelial cell density before and one year after surgery, in the two groups.

Results:

In the group 1, there was statistically significant reduction between before and after surgery in the median inferior endothelial cell density (median difference -557.8 cells/mm2; p = 0.028). In the group 2, there was statistically significant reduction in the median central endothelial cell density (median difference -229 cells/mm2; p = 0.018), superior endothelial cell density (median difference -557.cells/mm2; p = 0.028), temporal endothelial cell density (median difference -361 cells/mm2; p = 0.018), and nasal endothelial cell density (median difference -305.8 cells/mm2; p = 0.043).

Conclusions:

The surgical technique allowing the slightest endothelial reduction is the technique of removing the lens with the section of two parts. Despite manipulation of the lens in the anterior chamber, reduction in endothelial cells is less. Further studies with larger group need to be done.

Financial Disclosure:

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