Long-Term Destiny of Corneal Endothelial Cells in Anterior Chamber Intraocular Lens-Implanted Eyes

Abstract

Purpose. To investigate the long-term changes of corneal endothelial cells (EC) in anterior chamber intraocular lens- (AC-IOL-) implanted eyes. Methods. Retrospective study. We included 37 eyes (25 patients) that received AC-IOL implantation previously in the Eye and ENT Hospital of Fudan University between 1995 and 2016. Follow-up outcomes included the best-corrected visual acuity (BCVA), endothelial cell density, hexagonality, coefficient of variance, and central corneal thickness. Results. In total, 23 eyes (62.16%) with phakic and 14 eyes (37.84%) with aphakic AC-IOLs were included. Among these, 3 eyes (8.11%) were angle-supported AC-IOLs and 34 eyes (91.89%) were Artisan iris-fixated AC-IOLs. The mean age of patients was 41.40 ± 17.17 years, and the mean follow-up time was 12.12 ± 4.71 years in our study. At the follow-up time, corneal decompensation existed in 3 angle-supported AC-IOL eyes with a rate of 100% and 15 iris-fixated AC-IOL eyes with a rate of 44.12%. AC-IOL displacement occurred in 14 (41.18%) iris-fixated AC-IOL eyes. In the 19 iris-fixated AC-IOL eyes without corneal decompensation, significant changes also took place in corneal endothelial cells. The endothelial cell density decreased from 2843.26 ± 300.76 to 2015.58 ± 567.99 cells/mm2 (29.1% loss, P < 0.001 ) and hexagonality decreased from 51.21 ± 7.83 to 42.53 ± 9.17 (%) (16.9% loss, P < 0.001 ). The Kaplan–Meier survival curve also demonstrated the accumulated expectation rates of corneal endothelial cell decomposition for AC-IOLs with a median survival time of 12 years. Conclusion. We reported a significant chronic loss and long-term decompensation destiny of corneal endothelial cells in AC-IOL eyes. Semiannual or annual follow-up and evaluation of endothelial cells should be conducted in AC-IOL-implanted patients.

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia

“…AC-IOL implantation may be subjected to risks of corneal endothelial cell loss [18] . In a 12-year follow-up study of AC-IOL implanted eyes, it was found that the loss rate of corneal endothelium was 29.1% [25] . However, microspherophakic patients are at high risks of corneal endothelial cell loss because the lens may move forward and injure the corneal endothelium [8,11] .…”

Descemet membrane endothelial keratoplasty in complex eyes

“…But any intraocular surgery and particularly anterior chamber surgeries can cause direct trauma to corneal endothelium and ultimately lead to bullous keratopathy [9]. In addition, uveitis [10], toxic anterior segment syndrome [11], and anterior chamber intraocular lenses (ACIOL's) [12] can cause acute or chronic failure of endothelium. In the United States in 2019, 4.6% of PKP's and 17.3% of endothelial keratoplasty's were done for corneal edema after cataract surgery [1].…”

Operacja wtórnego wszczepienia soczewki transskleralnej metodą bezszwową – obserwacje własne

“…The choice of the implantation method and location is difficult and should be based on the indications and the patient's clinical condition (cause of aphakia, age, depth of the anterior chamber, presence of other ophthalmic diseases). Transscleral implantation avoids some of the complications associated with the other two methods, such as the risk of corneal decompensation or angle closure [3]. In cases of the patients described in this study, a Carlevale™ lens with sutureless transscleral fixation was used.…”