Paired-eye comparison of corneal endothelial cell counts after unilateral iris-claw phakic intraocular lens implantation

J Cataract Refract Surg. 2016 Jan;42(1):117-26. doi: 10.1016/j.jcrs.2015.08.018.


Purpose: To compare the corneal endothelial cell density (ECD) after unilateral iris-claw phakic intraocular lens (pIOL) implantation.

Setting: Instituto de Microcirugia Ocular, Barcelona, Spain.

Design: 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.

Financial disclosure: 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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cataract Extraction*
  • Cell Count
  • Corneal Endothelial Cell Loss / physiopathology
  • Endothelium, Corneal / pathology*
  • Female
  • Humans
  • Iris / surgery
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Phakic Intraocular Lenses*
  • Refraction, Ocular / physiology
  • Refractive Surgical Procedures
  • Retrospective Studies
  • Visual Acuity / physiology
  • Young Adult