title: Paired-eye comparison of corneal endothelial cell counts after unilateral iris-claw phakic intraocular lens implantation.
abstract: OBJECTIVE
  To compare the corneal endothelial cell density (ECD) after unilateral iris-claw phakic intraocular lens (pIOL) implantation.
  
  
  METHODS
  Instituto de Microcirugia Ocular, Barcelona, Spain.
  
  
  METHODS
  Retrospective interventional nonrandomized paired-eye comparison.
  
  
  METHODS
  Patients who had pIOL implantation in 1 eye and corneal refractive surgery (Group 1) or no surgery in the fellow eye (Group 2) between 1998 and 2010 were included. The main outcome measures were central corneal ECD and the percentage of corneal endothelial cell loss. Secondary outcome measures were uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction, and complications. Outcome measures were analyzed 1, 5, and 10 years postoperatively.
  
  
  RESULTS
  Both groups comprised 29 patients. Ten years after surgery, the mean endothelial cell loss was 6.41% ± 8.02% (SD) (Group 1, iris-claw pIOLs), 5.59% ± 5.98% (Group 1, corneal refractive surgery), 7.84% ± 6.83% (Group 2, iris-claw pIOLs), and 6.74% ± 3.97% (Group 2, no surgery). No significant endothelial cell loss was observed after pIOL implantation or corneal refractive surgery at any timepoint (P > .05). No significant differences were observed in the percentage of endothelial cell loss between the groups (P > .05).
  
  
  CONCLUSIONS
  Iris-claw pIOL implantation did not produce significant corneal endothelial cell loss up to 10 years after surgery compared with corneal refractive surgery and unoperated eyes when strict inclusion criteria were met.
  
  
  BACKGROUND
  Dr. Güell is a consultant to Ophtec BV and Carl Zeiss Meditec AG. No other author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From Instituto de Microcirugia Ocular (Morral, Güell, Elies, Gris, Manero) and Universitat Autonoma de Barcelona (Güell), Barcelona, Spain; European School for Advanced Studies in Ophthalmology (Güell), Lugano, Switzerland; Cornea and Refractive Surgery Department (El Husseiny), Research Institute of Ophthalmology, Giza, Egypt. Electronic address: merce.morral@gmail.com.
authors.forename: Merce
authors.initials: M
authors.lastname: Morral
authors.affiliation: From Instituto de Microcirugia Ocular (Morral, Güell, Elies, Gris, Manero) and Universitat Autonoma de Barcelona (Güell), Barcelona, Spain; European School for Advanced Studies in Ophthalmology (Güell), Lugano, Switzerland; Cornea and Refractive Surgery Department (El Husseiny), Research Institute of Ophthalmology, Giza, Egypt.
authors.forename: José L
authors.initials: JL
authors.lastname: Güell
authors.affiliation: From Instituto de Microcirugia Ocular (Morral, Güell, Elies, Gris, Manero) and Universitat Autonoma de Barcelona (Güell), Barcelona, Spain; European School for Advanced Studies in Ophthalmology (Güell), Lugano, Switzerland; Cornea and Refractive Surgery Department (El Husseiny), Research Institute of Ophthalmology, Giza, Egypt.
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: El Husseiny
authors.affiliation: From Instituto de Microcirugia Ocular (Morral, Güell, Elies, Gris, Manero) and Universitat Autonoma de Barcelona (Güell), Barcelona, Spain; European School for Advanced Studies in Ophthalmology (Güell), Lugano, Switzerland; Cornea and Refractive Surgery Department (El Husseiny), Research Institute of Ophthalmology, Giza, Egypt.
authors.forename: Daniel
authors.initials: D
authors.lastname: Elies
authors.affiliation: From Instituto de Microcirugia Ocular (Morral, Güell, Elies, Gris, Manero) and Universitat Autonoma de Barcelona (Güell), Barcelona, Spain; European School for Advanced Studies in Ophthalmology (Güell), Lugano, Switzerland; Cornea and Refractive Surgery Department (El Husseiny), Research Institute of Ophthalmology, Giza, Egypt.
authors.forename: Oscar
authors.initials: O
authors.lastname: Gris
authors.affiliation: From Instituto de Microcirugia Ocular (Morral, Güell, Elies, Gris, Manero) and Universitat Autonoma de Barcelona (Güell), Barcelona, Spain; European School for Advanced Studies in Ophthalmology (Güell), Lugano, Switzerland; Cornea and Refractive Surgery Department (El Husseiny), Research Institute of Ophthalmology, Giza, Egypt.
authors.forename: Felicidad
authors.initials: F
authors.lastname: Manero
mesh_terms: D000328:Adult; D002387:Cataract Extraction; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000503:physiopathology; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D007498:Iris / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D054140:Refractive Surgical Procedures; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult