No abstract

Our study shows chronic subclinical inflammation between 1 and 2 years after implantation of both IOL types.

Endothelial cell loss during the first year was similar in eyes with Worst-Fechner and Baikoff ZB5M lenses; however, at 2 years after surgery, endothelial cell loss was higher in eyes with Worst-Fechner lenses than it was in eyes with Baikoff ZB5M lenses.

PURPOSE: To evaluate the visual and refractive stability and the potential long-term risks associated with ZB5M phakic intraocular lens (PIOL) implantation. METHODS: A retrospective, non-randomized, cumulative clinical study was performed over 12 years in a consecutive group of 225 eyes implanted with the ZB5M PIOL. The main analyzed variables were visual and refractive outcomes (best spectacle-corrected visual acuity [BSCVA], uncorrected visual acuity [UCVA], and spherical equivalent), endothelial cell density, and postoperative complications. RESULTS: Mean preoperative spherical equivalent refraction was -17.23±7.69 diopters (D) and 12 years postoperatively it was -1.80+0.80 D. Mean BSCVA at 1- and 12-year follow-up was 0.38±0.19 and 0.57+0.18, respectively (Wilcoxon test, P<.001). At 12 years postoperatively, 3.5% of eyes lost 3*2 lines of BSCVA. An initial 10.6% reduction in endothelial cell density was noted in the first year, followed by a mean annual rate of decrease of 1.78%. The cumulative incidence of pupil ovalization was 34.7% (78 eyes), and there was no statistical correlation with endothelial cell impairment. Bilateral hypertensive uveitis was diagnosed in 3 (1.33%) eyes. CONCLUSIONS: The ZB5M PIOL offers good refractive outcomes and stability in the long-term; however, endothelial cell loss increases over 12 years, requiring annual endothelial cell counts. [J Refract Surg. 2007;23:147-158.]

We report the spontaneous resolution of a massive detachment of Descemet's membrane 10 months after uneventful phacoemulsification. Diagnosis of the detachment was delayed because of severe corneal edema; thus, surgery was not performed. We propose that this complication of severe corneal edema after cataract surgery be considered and, given its excellent outcome, we recommend surgical treatment.