Rapidly increasing late loss of corneal endothelial density with refractive iris-claw IOLs: case series

Poster Details

First Author: V.Miranda PORTUGAL

Co Author(s):    R. Massa   M. Lume   R. Salgado   M. Ceu     

Abstract Details

Purpose:

To review a case series of late endothelial cell loss due to refractive iris-claw IOLs and evaluate its possible causes

Setting:

Ophthalmology Department, Hospital de Santo Antonio, Porto, Portugal

Methods:

All case files of patients with endothelial cell loss associated with iris-claw IOLs (Artisan) and subjected to explantation during 2011 were reviewed retrospectively.

Results:

The mean age of the 7 patients (13 eyes) at IOL implantation was 38.7 years (range 31 to 46 years) and at time of IOL explantation, 49.4 years (range 44.5 to 55.6 years). In the first five years of follow-up, mean annual endothelial cell loss was inferior to -5.0%. At the sixth year, it climbed to -10.0% (range: +3.5% to -39.9%); -11.9% (range: +1.2% to -28.8%) at the seventh year; -14.9% (range: +2.9% to -27.1%) at the eighth year; -19.2% (range: +6.5% to -41.5%) at the ninth year; -14.5% (range: -11.5 to -17.7%) thereafter; IOL explantation occurred a mean of 11.2 years after IOL implantation. All patients denied chronic eye rubbing. However, the mean distance between the central corneal endothelium and the IOL progressively decreased over the years reaching a mean of 1720 ?m (range: 1550 to 2020 ?m) at time of IOL explantation.

Conclusions:

Artisan phakic IOL implantation has been extensively tested and is considered to be safe and effective for high refractive error corrections. However, an annual endothelial cell count analysis remains highly recommended in order to detect potential progressive cell loss at an early stage, specially in older patients. FINANCIAL DISCLOSURE?: No