Comparison of the Biometric Characteristics After Long-term Implantation of Iris-fixated Phakic Intraocular Lens in Explanted and Nonexplanted Groups of Eyes.

Am J Ophthalmol

From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.); From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.). Electronic address:

Published: September 2024

AI Article Synopsis

  • The study analyzes the biometric traits of the anterior chamber in patients with significant endothelial cell loss (ECL) who needed phakic intraocular lens (pIOL) explantation compared to those who did not.
  • Conducted retroactively in Lima, Peru, the research included patients who received pIOLs from 2001 to 2012, assessing various eye health metrics like endothelial cell count and optical coherence tomography.
  • Results revealed that patients in the explanted group experienced a higher annual percentage of ECL and lower minimum endothelial lens distance, indicating that both annual ECL rates and minimum distances can reliably differentiate between the two patient groups.

Article Abstract

Purpose: To evaluate and compare the biometric characteristics of the anterior chamber of a group of patients with significant endothelial cell loss (ECL) who required phakic intraocular lens (pIOL) explantation and a group of patients who did not fulfill the explantation criteria related to corneal decompensation.

Design: Retrospective, consecutive, interventional case series.

Methods: The study included all consecutive patients receiving a pIOL implantation at Oftalmosalud Instituto de Ojos, Lima, Peru, between 2001 and 2012. The explanted group (E group) consisted of eyes in which the pIOLs were explanted due to ECL, and the nonexplanted group (NE group) consisted of eyes randomly selected in which the pIOL was not explanted with a minimum follow-up time of 8 years. Slit-lamp biomicroscopy, visual acuity, refraction, endothelial cell count, and anterior segment optical coherence tomography were assessed at the preoperative evaluation for both groups and before explantation in the E group and 8 years post-implantation in the NE group.

Results: pIOLs were implanted in 265 eyes. The annual percentage of ECL was 1.47% and 5.55% in the NE group and E group, respectively (P < .001). The mean minimum endothelial lens distance (ELD) was 1.44 ± 0.22 mm and 1.05 ± 0.23 mm in the NE group and E group, respectively (P < 0.001). The mean time for explantation was 12.58 ± 3.79 years for the E group. Annual ECL could accurately discriminate between the NE group and E group; a cutoff point of 3.5 (%/year) or 86.5 (cells/years) had a 100% sensitivity and specificity. A cutoff of 1.21 mm in the minimum ELD has a 91% sensitivity and 79% specificity to discriminate between the E group and NE group.

Conclusions: pIOL explantation due to ECL occurs in eyes with a significantly postoperative lower minimum ELD. Annual ECL and minimum ELC can effectively discriminate between the E and NE groups.

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Source
http://dx.doi.org/10.1016/j.ajo.2024.02.011DOI Listing

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