title: Phakic intraocular lens: Two-year results and comparison of endothelial cell loss with iris-fixated intraocular lenses.
abstract: OBJECTIVE
  To evaluate the efficacy, safety, and stability of a foldable angle-supported Acrysof Cachet phakic intraocular lens (pIOL) to correct moderate to high myopia and compare endothelial cell loss after iris-fixated Artisan and Artiflex pIOL implantation.
  
  
  METHODS
  University Eye Clinic Maastricht, the Netherlands.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Foldable angle-supported pIOL implantation for myopia ranging from -6.0 to -16.5 diopters (D) was done. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, spherical equivalent (SE), and adverse events were documented preoperatively and 6 months and 1 and 2 years postoperatively. Endothelial cell loss after implantation of the foldable angle-supported pIOL and iris-fixated pIOLs was compared 6 months and 1 and 2 years postoperatively.
  
  
  RESULTS
  There were 158 eyes. The UDVA was equal to or more than 20/25 in 95% of eyes at 1 and 2 years postoperatively. The mean SE was -0.17 D ± 0.43 (SD) 2 years postoperatively. One patient developed pupil ovalization, resulting in explantation of the pIOL from both eyes. Acute endothelial cell loss in the foldable angle-supported pIOL group was -3.2% ± 0.7%, significantly higher than after iris-fixated pIOL implantation. Chronic endothelial cell loss from 6 to 24 months after surgery was -3.8% ± 0.7%. At the 2-year follow-up, the chronic endothelial cell loss in the foldable angle-supported pIOL group was not different than with iris-fixated pIOLs (P > .05).
  
  
  CONCLUSIONS
  The foldable angle-supported pIOL effectively corrected moderate to high myopia. However, acute surgical endothelial cell loss was significantly higher than with iris-fixated pIOLs.
  
  
  BACKGROUND
  Dr. Nuijts is a consultant to Alcon Laboratories, Inc., Théa Pharma GmbH, and ASICO LLC; he has received study grants from Acufocus, Inc., Alcon Laboratories, Inc., Carl Zeiss Meditec AG, Ophtec BV, and Physiol S.A. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Andreas A S
authors.initials: AA
authors.lastname: Aerts
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Soraya M R
authors.initials: SM
authors.lastname: Jonker
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Laura H P
authors.initials: LH
authors.lastname: Wielders
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Tos T J M
authors.initials: TT
authors.lastname: Berendschot
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Muriël
authors.initials: M
authors.lastname: Doors
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: John
authors.initials: J
authors.lastname: De Brabander
authors.affiliation: From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address: rudy.nuijts@mumc.nl.
authors.forename: Rudy M M A
authors.initials: RM
authors.lastname: Nuijts
mesh_terms: D000328:Adult; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology