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  • Title: Long-Term Effect of Anterior Chamber Depth on Endothelial Cell Density in Patients With Iris-Fixated Phakic Intraocular Lenses.
    Author: Eldanasoury AM, Roozbahani M, Tolees S, Arana C.
    Journal: J Refract Surg; 2019 Aug 01; 35(8):493-500. PubMed ID: 31393987.
    Abstract:
    PURPOSE: To evaluate the long-term endothelial cell density (ECD) change and its correlation with preoperative anterior chamber depth (ACD) and aqueous depth (AQD) in patients with iris-fixated phakic intraocular lenses (pIOLs). METHODS: A total of 90 eyes from 57 patients who underwent pIOL implantation were retrospectively enrolled. Correlation between ACD and endothelial cell loss (ECL) was investigated. Optimal cut-off values for ACD and AQD were assessed. RESULTS: The average follow-up period was 11.8 ± 2.0 years (range: 9.1 to 17.3 years). Compared to the baseline data, the mean ECD change was -894 ± 732 cells/mm2 (range: -2,281 to 389 cells/mm2). The mean ECD change from baseline was -53.5% ± 19.1% (range: -75.1% to -5.2%) in eyes with preoperative ACD of 3.20 mm or greater -26.0% ± 26.6% (range: -74.1% to 0.9%) in eyes with ACD of 3.21 to 3.49 mm, and -5.2 ± 8.7% (range: -21.3% to 16.8%) in eyes with ACD of 3.50 mm or greater (P < .001). No eyes with ACD of 3.50 mm or greater had significant endothelial cell loss (SECL), whereas 84% of the eyes with ACD of 3.20 mm or less experienced SECL (P < .001). There was a significant negative correlation between ECL and ACD (r = -0.70, P < .001) and AQD (r = -0.65, P < .001). Receiver operating characteristic curve analysis revealed that ACD of 3.35 mm provides 84% sensitivity and 88% specificity and AQD of 2.75 mm provides 88% sensitivity and 81% specificity for preventing SECL. CONCLUSIONS: Smaller ACD and AQD are significantly correlated with more ECL. Minimum ACD of 3.35 mm or AQD of 2.75 mm are recommended for better long-term endothelial safety. [J Refract Surg. 2019;35(8):493-500.].
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