Long-term endothelial changes after implantation of anterior chamber intraocular lenses in cataract surgery.
OBJECTIVE
To determine and quantify corneal endothelial damage after primary or secondary implantation of anterior chamber intraocular lenses (AC IOLs).


METHODS
Eye Clinic, University of Trieste, Trieste, Italy.


METHODS
This retrospective study comprised 125 patients who had implantation of an AC IOL from January 1987 to December 1998. The mean follow-up was 5.2 years. The IOLs were the Domilens Chiron Vision Z (n = 52), the Iolab U85J (n = 38), and the AMO AC51B (n = 35). The Konan specular microscope was used to perform full morphometric analysis of the corneal endothelium. The values obtained were compared with those in fellow eyes, which were phakic or pseudophakic with a posterior chamber IOL (PC IOL). Two years later, 63 patients (mean follow-up 2.1 years) had another morphometric analysis and the values obtained were compared with those in the same eye at the previous examination. The Student t test for unpaired groups was used to compare the results at a 5% significance level.


RESULTS
The mean endothelial cell density (ECD) was significantly lower in eyes with primary or secondary AC IOL implantation than in unoperated phakic eyes (P<.01). Patients who had primary AC IOL implantation in 1 eye and PC IOL implantation in the fellow eye had a difference in ECD that was not statistically significant. The endothelial cell difference was significantly greater in aphakic patients who had a secondary AC IOL implantation (P<.05). The ECD ranged from 1015 to 2980 cells/mm(2). The endothelium in the various groups showed no significant changes in the coefficient of variation (CV) in cell size. The ECD and endothelial CV in the same eyes at the second examination were not significantly different from the values 2 years previously.


CONCLUSIONS
Anterior chamber IOL implantation did not appear to alter corneal endothelial function. Results indicate that the endothelial cell loss was related to surgical trauma rather than the presence of an IOL in the anterior chamber.
Ravalico
Giuseppe
G
Eye Clinic, University of Trieste, Trieste, Italy.
Botteri
Elena
E
Baccara
Fabio
F
D000368:Aged; D000867:Anterior Chamber / Q000601:surgery*; D002387:Cataract Extraction; D002452:Cell Count; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007908:Lens, Crystalline / Q000502:physiology; D008297:Male; D019591:Pseudophakia / Q000150:complications; D012189:Retrospective Studies