A Comparative Study of Endothelial Cell Loss after the Implantation of Posterior Chamber Phakic IOL (ICL) Versus Foldable Anterior Chamber Iris-Fixated Phakic IOL (Veriflex),HAZEM M. YASSIN, AHMED E.M. HABIB, AHMED A. ABD EL-KADER and NAHLA B. ABU HUSSEIN
Abstract
Purpose: To evaluate the endothelial cell loss after im-plantation of posterior chamber phakic intraocular lenses as compared to anterior chamber iris fixated phakic intraocular lenses.
Setting: Al-Oyoun Al Dawli Hospital, Cairo, Egypt.
Methods: A comparative prospective non randomized study involved 30 eyes divided into 2 groups. Group A included 15 eyes of 9 patients that have implanted posterior chamber phakic intraocular lens (ICL, Staar Surgical). Group B included 15 eyes of 8 patients that have implanted foldable anterior chamber iris fixated phakic intraocular lens (Veriflex, AMO). Non contact specular microscopy was done preoperatively and at the 3rd, 6th and 12th months postoperatively.
Results: In both groups, there was a statistically significant loss of endothelial cells over time at 3 months, 6 months and 12 months postoperatively (p<0.001). In the ICL group, the mean percentage loss of endothelial cells at 3 months, 6 months and 12 months postoperatively was 1.34%±0.51, 2.53%±0.9 and 4.74%±1.24 respectively. In the Veriflex group, the mean % loss of endothelial cells at 3 months, 6 months and 12 months postoperatively was 2.42%±2.4, 4.0%±2.86 and 5.47±3.23 respectively. However, the difference between both groups was statistically insignificant (p=0.749).
Conclusion: Continuous endothelial cell loss was observed after the implantation of posterior chamber phakic IOLs (ICL) (Implantable collamer lens) as well as in anterior chamber iris fixated foldable phakic IOLs (Verifelx) during the first year of postoperative follow-up. However the differences in cell loss observed between the two groups of patients were statisticaslly insignificant. Further analysis of the relation between endothelial cell loss and the distance between the corneal endothelium and the implanted lens may be required in further studies. Long term follow-up of those patients could help demonstrate the long term pattern of cell loss.