Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference

Tiago Bravo Ferreira, Joana PortelinhaEgas Moniz Hospital, Lisbon, PortugalPurpose: To evaluate the distance between the endothelial surface of the cornea to the anterior edge of an Artiflex® phakic intraocular lens (IOL) implant to improve the safety profile of this implant.Methods: This i...

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Autores principales:	Ferreira TB, Portelinha J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/eab1d96a23334b41867230095261890a
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spelling	oai:doaj.org-article:eab1d96a23334b41867230095261890a2021-12-02T04:30:10ZEndothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference1177-5483https://doaj.org/article/eab1d96a23334b41867230095261890a2014-01-01T00:00:00Zhttp://www.dovepress.com/endothelial-distance-after-phakic-iris-fixated-intraocular-lens-implan-a15549https://doaj.org/toc/1177-5483 Tiago Bravo Ferreira, Joana PortelinhaEgas Moniz Hospital, Lisbon, PortugalPurpose: To evaluate the distance between the endothelial surface of the cornea to the anterior edge of an Artiflex® phakic intraocular lens (IOL) implant to improve the safety profile of this implant.Methods: This is a retrospective clinical case series of 45 patients who had Artiflex phakic IOL implantation (Artiflex p-IOL) with a follow-up period of 3 years. A Pentacam HR imaging system was used to measure the distance from various points of the anterior edge of the Artiflex IOL to the endothelial surface of the cornea, which we called endothelial–IOL (E–IOL) distance, in 45 eyes. The E–IOL distances were assessed at 1, 3, 6, 12, 24, and 36 months. Corresponding correlations of central endothelial distance to temporal and nasal edges and center of the IOL anterior surface were tabulated.Results: Mean follow-up was 21.39±11.28 months. A statistically significant reduction of the E–IOL distance was observed over the follow-up period (P<0.05), with the mean annual reduction being 24.70 µm. A strong positive correlation between the E–IOL distance of the edges of the IOL and the central distance was observed (correlation coefficients nasal/central: month 1, 0.905; month 36, 0.806; temporal/central: month 1, 0.906; month 36, 0.806; P<0.001). Moderate negative correlations were found between the spherical equivalent power of the implanted IOL and the E–IOL distance (correlation coefficients -0.271 to -0.412, P>0.05). For an E–IOL distance of the IOL edge >1,500 µm, the distance from the endothelium to the central point of the p-IOL optic should be a minimum of 1,700 µm to improve the safety profile for Artiflex p-IOL implantation and reduce the potential complication of accelerated endothelial cell loss.Conclusion: After Artiflex IOL implantation, the mean annual reduction of the E–IOL distance was 25 µm. A negative correlation existed between the spherical equivalent power of the implanted IOL and the postoperative E–IOL distance. The minimum E–IOL distance from the center of the IOL to minimize the risk of endothelial cell loss was 1.7 mm. This distance, as is the 1.5 mm initially proposed by Baikoff, is a postoperative value. We cannot make that assumption for the preoperative evaluation, as the morphometry of the anterior chamber changes with the implant.Keywords: phakic IOL, endothelium, iris-fixated phakic IOLFerreira TBPortelinha JDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 255-261 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Ferreira TB Portelinha J Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
description	Tiago Bravo Ferreira, Joana PortelinhaEgas Moniz Hospital, Lisbon, PortugalPurpose: To evaluate the distance between the endothelial surface of the cornea to the anterior edge of an Artiflex® phakic intraocular lens (IOL) implant to improve the safety profile of this implant.Methods: This is a retrospective clinical case series of 45 patients who had Artiflex phakic IOL implantation (Artiflex p-IOL) with a follow-up period of 3 years. A Pentacam HR imaging system was used to measure the distance from various points of the anterior edge of the Artiflex IOL to the endothelial surface of the cornea, which we called endothelial–IOL (E–IOL) distance, in 45 eyes. The E–IOL distances were assessed at 1, 3, 6, 12, 24, and 36 months. Corresponding correlations of central endothelial distance to temporal and nasal edges and center of the IOL anterior surface were tabulated.Results: Mean follow-up was 21.39±11.28 months. A statistically significant reduction of the E–IOL distance was observed over the follow-up period (P<0.05), with the mean annual reduction being 24.70 µm. A strong positive correlation between the E–IOL distance of the edges of the IOL and the central distance was observed (correlation coefficients nasal/central: month 1, 0.905; month 36, 0.806; temporal/central: month 1, 0.906; month 36, 0.806; P<0.001). Moderate negative correlations were found between the spherical equivalent power of the implanted IOL and the E–IOL distance (correlation coefficients -0.271 to -0.412, P>0.05). For an E–IOL distance of the IOL edge >1,500 µm, the distance from the endothelium to the central point of the p-IOL optic should be a minimum of 1,700 µm to improve the safety profile for Artiflex p-IOL implantation and reduce the potential complication of accelerated endothelial cell loss.Conclusion: After Artiflex IOL implantation, the mean annual reduction of the E–IOL distance was 25 µm. A negative correlation existed between the spherical equivalent power of the implanted IOL and the postoperative E–IOL distance. The minimum E–IOL distance from the center of the IOL to minimize the risk of endothelial cell loss was 1.7 mm. This distance, as is the 1.5 mm initially proposed by Baikoff, is a postoperative value. We cannot make that assumption for the preoperative evaluation, as the morphometry of the anterior chamber changes with the implant.Keywords: phakic IOL, endothelium, iris-fixated phakic IOL
format	article
author	Ferreira TB Portelinha J
author_facet	Ferreira TB Portelinha J
author_sort	Ferreira TB
title	Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
title_short	Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
title_full	Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
title_fullStr	Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
title_full_unstemmed	Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
title_sort	endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/eab1d96a23334b41867230095261890a
work_keys_str_mv	AT ferreiratb endothelialdistanceafterphakicirisfixatedintraocularlensimplantationanewsafetyreference AT portelinhaj endothelialdistanceafterphakicirisfixatedintraocularlensimplantationanewsafetyreference
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Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference

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