title: Phakic Intraocular Lens Implantation: Refractive Outcome and Safety in Patients with Anterior Chamber Depth between 2.8 and 3.0 versus ≥3.0 mm.
abstract: OBJECTIVE
  To compare endothelial cell (EC) variation after anterior chamber phakic intraocular lens (AC-pIOL) implantation in highly myopic patients with a preoperative anterior chamber depth (ACD) between 2.8 and 3.0 versus ≥3.0 mm.
  
  
  METHODS
  A total of 280 eyes submitted to primary AC-pIOL implantation were analyzed. Pre- and postoperative values for uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, ACD (endothelial surface), and EC count were collected. The eyes were divided into 2 groups: group A - ACD between 2.8 and 3.0 mm; group B - ACD ≥3.0 mm. Mean global EC loss (ECL) and loss for each ACD group, according to pIOL type, were analyzed.
  
  
  RESULTS
  Significant improvement of the spherical equivalent (-11.38 ± 4.57 vs. -0.49 ± 0.79; p = 0.000) and a significant decrease in EC density (2,810.95 ± 343.88 vs. 2,584.09 ± 374.88 cells/mm2; p = 0.000) were noted. The mean annual ECL was -2.19 ± 3.97%. Regarding group A (n = 80), a mean annual ECL of -2.06 ± 3.88% was registered, higher for the Acrysof Cachet® subtype, while group B (n = 200) showed -2.25 ± 4.01% ECL, higher for the Verisyse® subtype. There was no significant difference between the groups (p = 0.96).
  
  
  CONCLUSIONS
  AC-pIOL implantation significantly improves the spherical equivalent in myopic patients. The mean annual ECL after pIOL implantation was higher in the larger ACD group, but this value was not statistically significant. A 2.8-mm ACD value seems to be a safe cutoff for AC-pIOL implantation.
authors.affiliation: Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Marta G
authors.initials: MG
authors.lastname: Guerra
authors.forename: Andreia M M
authors.initials: AMM
authors.lastname: Silva
authors.forename: Sara H M
authors.initials: SHM
authors.lastname: Marques
authors.forename: Sofia H
authors.initials: SH
authors.lastname: Melo
authors.forename: João A
authors.initials: JA
authors.lastname: Póvoa
authors.forename: Conceição
authors.initials: C
authors.lastname: Lobo
authors.forename: Joaquim Neto
authors.initials: JN
authors.lastname: Murta
mesh_terms: D000328:Adult; D000867:Anterior Chamber / Q000000981:diagnostic imaging*; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D011474:Prosthesis Design; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult