Long-Term Observation Of Corneal Endothelial Cell Changes After Iris-Fixated Phakic Intraocular Lens Explantation

Published 2022 - 40th Congress of the ESCRS

Reference: PP27.08 | Type: ESCRS 2022 - Posters | DOI: 10.82333/c944-v476

Authors: Minha Kim* ¹ , Tae Young Kim ² , Yong Woo Ji ³ , Ikhyun Jun ⁴ , Tae-Im Kim ⁴ , Kyoung Yul Seo ⁴ , Hyung Keun Lee ¹

¹Department of Ophthalmology,Institute of Vision Research, Yonsei University College of Medicine,Seoul,Korea, Republic Of;Department of Ophthalmology,Gangnam Severance Hospital, Yonsei University College of Medicine,Seoul,Korea, Republic Of, ²Department of Ophthalmology,Institute of Vision Research, Yonsei University College of Medicine,Seoul,Korea, Republic Of, ³Department of Ophthalmology,Institute of Vision Research, Yonsei University College of Medicine,Seoul,Korea, Republic Of;Department of Ophthalmology,Yongin Severance Hospital, Yonsei University College of Medicine,Seoul,Korea, Republic Of, ⁴Department of Ophthalmology,Institute of Vision Research, Yonsei University College of Medicine,Seoul,Korea, Republic Of;Department of Ophthalmology,Severance Hospital, Yonsei University College of Medicine,Seoul,Korea, Republic Of

Purpose

To report long-term corneal endothelial cell changes after iris-fixated phakic intraocular lens (pIOL) explantation in patients with endothelial damage and to investigate potential predictors of endothelial injury.

Setting

Institutional, retrospective

Methods

Retrospective review of clinical records of the eye which underwent pIOL explantation with corneal endothelial cell density (ECD), 2000 cells/mm2 at the time of the procedure. All patients were treated between April 2016 and March 2022 at a high-volume referral-based tertiary hospital. ECD and all corneal endothelial parameters were collected for a minimum of 6 months and at the last follow-up to analyze changes in parameters after pIOL explantation. The main outcome was the change in corneal endothelial parameters, including ECD, over long-term follow-up.

Results

This study included 56 eyes from 36 patients with an average age of 41.6 ± 7.7 years (range: 27–63). Mean ECD before explantation was 1386.0 ± 462.3 cells/mm2 (range: 622–1996), and the average duration of follow-up after explantation was 22.8 ± 20.2 months (range: 6-70.4). By the last follow-up, ECD had decreased from an initial value of 1386.0 cells/mm2 (median: 1502 cells/mm2, range: 622–1996 cells/mm2) to 1222.0 cells/mm2 (median: 1147 cells/ mm2, range: 501–1996 cells/mm2), representing a >11% decrease (P < 0.01). Especially, two years after explantation, ECD had significantly decreased by more than 25% to 1019.6 ± 368.6 (P < 0.01).

Conclusions

ECD decreased postoperatively in the long-term follow-up despite safe pIOL explantation. Moreover, the rate of ECD reduction after pIOL explantation is faster than that of normal aging endothelium.