Paired-Eye Comparison of Corneal Endothelial Cell Counts After Unilateral Iris-Claw Phakic IOL Versus Corneal Refractive Surgery
Purpose
To compare postoperative endothelial cell count changes after iris-claw phakic intraocular lens implantation vs corneal refractive surgery.
Methods
Retrospective comparative study including 64 eyes of 32 patients who received Artisan/Artiflex phakic intraocular lens (PIOL) implantation in one eye and LASIK in the contralateral eye between January 1998 and December 2012. Mean central endothelial cell counts (cECC) and percentage change in cECC from baseline to 1, 5 and 10 years were analyzed using specular microscopy (Konan, NONCON ROBO-CA, Fair Lawn, NJ, USA). Paired t-Student test was used to compare preoperative and postoperative data and to compare both groups. A P value of <0.05 was considered statistically significant.
Results
PIOL implantation presented a mean preoperative cECC of 2811±412 cells/mm2. Postoperatively, cECC was 2808±415 cells/mm2, 2630±419 cells/mm2, and 2539±710 cells/mm2 at 1, 5, and 10 years, respectively. Percentage change from baseline at 1, 5 and 10 years was -2.79%±12.13%, -5.24%±18.64%, and -5.26%±31.44% respectively. A statistically significant endothelial cell loss was found at 5 and 10 years postoperatively (p<0.05). LASIK surgery presented a mean preoperative cECC of 2812±371 cells/mm2. Postoperatively, cECC was 2847±467 cells/mm2, 2792±379 cells/mm2, and 2993±414 cells/mm2 at 1, 5, and 10 years, respectively. Percentage change from baseline at 1, 5 and 10 years was 1.49%±13.82%, and -2.3%±14.07%, and -2.8%±11.23% respectively. No statistically significant postoperative endothelial cell loss was found (p>0.05).
Conclusion
Compared to LASIK, Artisan/Artiflex iris-claw PIOL implantation resulted in a higher decrease in postoperative cECC, which was significant at 5 and 10 years of follow-up.