Long-term endothelial and visual safety in iris-fixated phakic intraocular lenses

Session Details

Session Title: Posterior Chamber Phakic IOLs

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 15:34

Venue: Free Paper Forum: Podium 3

First Author: : J.Providência PORTUGAL

Co Author(s): :    M. Raimundo   P. Gil   M. Guerra   J. Póvoa   C. Lobo   J. Neto-Murta              

Abstract Details

Purpose:

To investigate long-term endothelial cell density (ECD) changes following implantation of two types of iris-fixated phakic intraocular lenses (pIOLs), rigid and flexible.

Setting:

Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

Methods:

Retrospective study including 98 eyes receiving pIOLs, either rigid (Artisan Myopia, Ophtec BV) or flexible (Artiflex Myopia, Ophtec BV), with a minimum follow-up of 5 years, all implanted with a minimum endothelial anterior chamber depth (endoACD) of 2.8 mm. Predictors of ECD loss were evaluated using linear regression analysis. The best spectacle corrected visual acuity (BSCVA) at the 5-year visit was used to calculate the safety index (post-operative BSCVA / pre-operative BSCVA).

Results:

We included 49 eyes in the rigid pIOL group and 49 eyes in the flexible pIOL group. The annualized ECD loss was -55.3 cells/mm2 (-1.9%/year) in the rigid pIOL group and 34.4 cells/mm2 (-1.2%/year) in the flexible pIOL group (p=0.060). In the rigid pIOL group, increased absolute preoperative ECD and decreasing endoACD were independent predictors of a higher ECD loss rate in a bivariate linear regression model (p=0.022 and p=0.005, respectively). In the flexible pIOL group, increased absolute preoperative ECD predicted increased ECD loss rate in univariate regression analysis (p=0.007). The safety index was 1.33±0.33 and 1.30±0.37, respectively.

Conclusions:

Similar and higher than physiologic annualized ECD loss rates were found in both groups in a long-term follow-up cohort. While increased preoperative ECD predicted a higher ECD loss rate in both groups, a smaller endoACD was only a significant predictor in the rigid pIOL group. This suggests that variations in preoperative endoACD (always above the 2.8 mm required for implantation) may not significantly influence future ECD loss rate in flexible pIOLs to the extent that it appears to do in rigid pIOLs. Both pIOLs types attained a safety index equal or larger than 1.0 at 5 years of follow-up.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a competing company