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Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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Corneal endothelial changes after phakic IOL surgery

Poster Details

First Author: J.Braga PORTUGAL

Co Author(s):    J. Cardoso Costa   F. Neves   A. Ribeiro   T. Pacheco   C. Arede        

Abstract Details


To evaluate the corneal endothelial cells size and density changes after phakic IOL surgery over a follow-up period of one to six years.


Centro Hospitalar Vila Nova de Gaia / Espinho, Vila Nova de Gaia, Portugal.


A retrospective review of the medical records of the patients who underwent refractive surgery with iris-claw phakic IOL Artisan and Artiflex, by Opthec, between January 2009 and March 2017. Inclusion criteria were: minimum anterior chamber depth (ACD) as recommended by the manufacturer; preoperative Corneal Endothelial Specular Microscopy (CESM) data available and a minimum follow-up period of one year with postoperative CESM. Data regarding patient age, preoperative and postoperative Best Corrected Visual Acuity (BCVA), ACD, lens specifications, endothelial cells density, average size and standard deviation on CESM, were analysed. Additional surgeries were also reported.


A total of 312 eyes were included: 229 Artiflex and 83 Artisan. The BCVA was 0.76 preoperative and 0.87 postoperative. The preoperative ACD measured from the endothelial was 3.2±0.23 mm (mean±SD): 3.25±0.19 mm with Artiflex and 3.11±0.27 mm with Artisan. During the first year after surgery there was a 2.6% decrease in endothelial cell density. The annual rate of cell density loss was 1.8% during the first 4 years (n=140) and 1.76% in 5 years (n=90). IOL explant due to endothelial damage occurred in 1.9% of cases (6 eyes of 3 patients), six years after implantation.


Phakic IOL are a refractive option for high miopic correction but are associated with endothelial changes that require continued monitoring. This study suggests that the greater endothelial cell loss occurs in the first year after surgery, with a lowering rate of density cell loss in the following four to five years.

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