The Use Of Critical Distance Measured With Anterion® As A Predictor Of Endothelial Cell Loss After Iris Fixation Phakic Intraocular Lens Implantation
Published 2023 - 41st Congress of the ESCRS
Reference: PO0979 | Type: Free paper | DOI: 10.82333/hy57-gq04
Authors: Joao Miguel Oliveira Leite* 1 , André Ferreira 2 , Beatriz Vieira 1 , Ana Carolina Abreu 1 , Sílvia Monteiro 1 , Maria Céu Pinto 1
1Ophthalmology,Centro Hospitalar Universitário de Santo António,Porto,Portugal, 2Ophthalmology,Centro Hospitalar Universitário de Santo António,Porto,Portugal;Biomedicine,Unit of Anatomy, Faculdade de Medicina da Universidade do Porto,Porto,Portugal
Purpose
The aim of this study was to evaluate the influence of minimum distance from the edge of the phakic intraocular lens (pIOL) to the endothelium (critical distance) measured at four different points using high-resolution swept-source optical coherence tomography (ANTERION® Heidelberg Engineering) on endothelial cells density (ECD).
Setting
Refractive Surgery Unit of Ophthalmology Department of Centro Hospitalar Universitário de Santo António, Oporto, Portugal.
Methods
A cross-sectional study was performed on patients who underwent Artiflex® implantation between 2003 and 2011. Eyes submitted to pIOL explantation or lost to follow-up were excluded. Demographic data were collected. All eyes underwent critical distance (CD) evaluation with ANTERION® on February of 2023 at four evaluation points: nasal (N), superior (S), temporal (T) and inferior (I). ECD (obtained through EM 4000, Tomey) and anterior chamber depth (ACD, obtained through Pentacam®, Oculus) were also evaluated. A mixed-effects linear regression was performed to assess the effect of CD on annual endothelial cell loss, adjusting for age.
Results
Eighty-eight eyes of 51 patients (64.7% female, mean±SD age 31.9±5.5 years) with a follow-up of 13.4±1.9 years were included. The mean±SD CD at N, T, I and S points were 1.5±0.3, 1.6±0.3, 1.5±0.4 and 1.6±0.3, with significant differences (N vs S points and S vs I, both p<0.001). Preoperatively, the mean±SD ACD and ECD were 3.2±0.3mm and 2884.0±379.6cell/mm2, with a decrease, respectively, to 3.0±0.3 mm (p<0.001) and 2279.1±355.5 cell/mm2 (p<0.001).Using a mean distance of 1.5mm in the linear model, a yearly ECD of 1.64%, 1.70%, 1.78% and 1.70% was predicted for N, T, S and I points, respectively. To predict an yearly ECD loss of 1%, the S distance presented the highest AUROC (0.65 vs 0.60, 0.60 and 0.52 for N, T and I points, respectively).
Conclusions
The evaluation of critical distances at the 4 different points seems to be relevant in the follow-up of patients with pIOL. The critical distance at the superior point seems to be the best predictor of ECD loss. In addition to ECD, the annual follow-up visits of patients with pIOL should include the measurement of critical distance by points and not only on the horizontal meridian.