The Risk Factors Of Decreased Corneal Endothelial Cell Density In Patients With Implantable Collamer Lens Explantation

This study evaluated   decreased cornea endothelial cell density (ECD) risk factors by analyzing 93 eyes of 93 posterior phakic Implantable Collamer Lens(ICL) explanted  patients.

Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea

The relevant risk factors of  pre-operative and post-operative  ECD  were evaluated by multiple regression analysis. The receiver operating  characteristic(ROC) curve was used to define the significant factors and cutoff values deciding the increase of ECD after ICL removal. 

Before ICL removal pre-operative ECD was significantly correlated with ICL implanted duration, WTW, anterior chamber angle (ACA), ICL peripheral thickness, ICL vaulting, vaulting/ACD ratio, and ICL pigmentation. At post-operative 6 month, 33 eyes (35.5 %) had decrease of ECD and 60 eyes  (64.5%) had increase.  Pre-operative ECD, ACA, vaulting, Vaulting/ACD, iris pigmentations were significant risk factors of post-operative ECD change. Pre-operative ECD showed the greatest area under the curve (AUC = 0.893) and showed a 84.8% sensitivity and 84.9% a specificity at a cutoff value of 1723 cells/mm²  in deciding the increase of post-operative ECD. 

The post-operative ECD increase can be observed after ICL removal, and pre-operative ECD might be the most relevant factor on deciding post-operatiive ECD change after ICL removal.