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Long-term endothelial cell loss with the iris-claw intraocular phakic lenses (Artisan®)

  • Refractive Surgery
  • Published:
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Abstract

Purpose

To evaluate the endothelial cell loss in patients with iris-claw phakic lenses (Artisan®) in a long-term follow-up.

Methods

We analyzed the medical records of patients who had undergone iris-claw phakic lens implantation and who had at least 5 years of follow-up.

Results

We included 67 eyes with myopic errors (follow-up 9.6 ± 3.0 years) and 10 eyes with mixed astigmatism or hyperopic errors (follow-up 8.8 ± 2.5 years). The mean total endothelial density loss at the last follow-up visit was 18.5% ± 17.0% and 10.5% ± 12.3%, respectively. 29.9% of the eyes in the myopic group and 20% in the hyperopic group lost more than 25% of the preoperative endothelial cell density. During the postoperative follow-up period, 60.8% of the eyes in the myopic group and 40% of the eyes in the hyperopic group lost a higher percentage than the expected physiological loss. Two eyes in the myopic group (3.0%) had a final cell density of less than 1200 cells/mm2. None of the variables studied had a statistically significant association with the percentage of annual endothelial loss in the postoperative period. Three phakic lenses were explanted: two by cataract and one by cataract and severe decrease of the endothelial density (862 cells/mm2).

Conclusions

There is a significant endothelial cell loss in a low percentage of the eyes with Artisan® lenses in the long term, and it can decrease to critical levels. Periodic endothelial density evaluations are required for these patients. The selection criteria of surgical candidates could be reevaluated.

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Authors and Affiliations

  1. Centro Oftalmológico Virgilio Galvis, FOSCAL Internacional, Calle 158 20–95, Consultorio 301, Torre C, Floridablanca, Colombia

    Virgilio Galvis, John F. Villamil, Alejandro Tello & Angélica María Prada

  2. Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia

    Virgilio Galvis, María Fernanda Acuña, Paul A. Camacho, Alejandro Tello, Sandra Lizeth Zambrano & Juan Vicente Espinoza

  3. Faculty of Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia

    Virgilio Galvis, María Fernanda Acuña, Paul A. Camacho, Alejandro Tello & Juan José Rey

  4. Faculty of Health Sciences, Universidad Industrial de Santander, Bucaramanga, Colombia

    John F. Villamil, Sandra Lizeth Zambrano & Juan Vicente Espinoza

  5. Instituto Universitario Fernández-Vega, Oviedo, Spain

    Jesús Merayo-Lloves

  6. Ophthalmology Department, Universidad de Oviedo, Oviedo, Spain

    Jesús Merayo-Lloves

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  1. Virgilio Galvis
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Correspondence to Alejandro Tello.

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Galvis, V., Villamil, J.F., Acuña, M.F. et al. Long-term endothelial cell loss with the iris-claw intraocular phakic lenses (Artisan®). Graefes Arch Clin Exp Ophthalmol 257, 2775–2787 (2019). https://doi.org/10.1007/s00417-019-04506-9

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