title: Influence of anterior chamber morphometrics on endothelial cell changes after phakic intraocular lens implantation.
abstract: OBJECTIVE
  To analyze the position of iris-fixated phakic intraocular lenses (pIOLs) using anterior segment optical coherence tomography (AS-OCT) and evaluate the effect of anterior chamber morphometrics on endothelial cell changes.
  
  
  METHODS
  Department of Ophthalmology, Academic Hospital Maastricht, The Netherlands.
  
  
  METHODS
  In this cross-sectional study, AS-OCT was used to measure the distances from the center and the edges of the pIOL to the corneal endothelium in 242 eyes with various models of myopic pIOLs. Endothelial cell measurements were performed preoperatively and at each follow-up examination.
  
  
  RESULTS
  The mean follow-up was 34.1 months+/-24.7 (SD) (range 3 months to 7 years). The mean distance between the edge of the pIOL and the endothelium was 1.37+/-0.22 mm. Although this distance was smaller than the safety value of 1.50 mm in 68.6% of the eyes, no eye developed corneal decompensation. There was a significant endothelial cell density (ECD) loss of 1.28%+/-8.46%, 3.25%+/-8.24%, and 5.02%+/-10.40% at 2 years, 5 years, and 7 years, respectively. Linear mixed-model analysis predicted a yearly ECD loss of 0.98% for a mean edge distance of 1.37 mm, 0.15% for an edge distance of 1.59 mm (mean plus 1 SD), and 1.80% for an edge distance of 1.15 mm (mean minus 1 SD).
  
  
  CONCLUSIONS
  A shorter distance between the edge of the pIOL and the endothelium was significantly associated with higher ECD loss. For safety reasons, the postoperative examination should include long-term evaluation of the anterior chamber morphometrics in addition to ECD counts.
authors.affiliation: Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: Muriël
authors.initials: M
authors.lastname: Doors
authors.forename: Diana W J K
authors.initials: DW
authors.lastname: Cals
authors.forename: Tos T J M
authors.initials: TT
authors.lastname: Berendschot
authors.forename: John
authors.initials: J
authors.lastname: de Brabander
authors.forename: Fred
authors.initials: F
authors.lastname: Hendrikse
authors.forename: Carroll A B
authors.initials: CA
authors.lastname: Webers
authors.forename: Rudy M M A
authors.initials: RM
authors.lastname: Nuijts
mesh_terms: D000293:Adolescent; D000328:Adult; D000867:Anterior Chamber / Q000473:pathology*; D001251:Astigmatism / Q000601:surgery; D002452:Cell Count; D003430:Cross-Sectional Studies; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D054120:Phakic Intraocular Lenses; D041623:Tomography, Optical Coherence; D055815:Young Adult