Long-Term Endothelial Cell Loss With Iris-Claw IOL
Narrative Responses:
Purpose
To evaluate long-term endothelial cell loss with the Iris-Claw IOL.
Methods
Retrospective study including 30 eyes implanted with the irisclaw IOL (249 myopic - 48 hyperopic). The endothelial cell density was calculated with the non contact Topcon SP2000 or SP3000 specular microscope.
Results
A high rate of severe endothelial loss (more than 50% compared to preoperative) occurs with both lenses in the long term. With the myopic Iris-Claw, a severe endothelial loss appears after 5 years in 8% of eyes. This rate increases progressively to 40% after 12 years. The endothelial damage occurs earlier with the hyperopic Iris-Claw lens. The rate of severe endothelial loss is 8% after 3 years and more than 40% after 8 years.
The rate of explantations due to endothelial loss is respectively 17% and 30% after 10 years.
Conclusion
Today, the main complication of anterior chamber phakic IOLs is major endothelial cell loss leading to an explantation and a risk for corneal decompensation. While several angle-supported phakic IOLs have shown short or middle term endothelial cell loss, the irisclaw IOL shows long term damage.