Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul.
J Refract Surg. 2011 Dec;27(12):881-6. doi: 10.3928/1081597X-20110802-03. Epub 2011 Aug 8.
To evaluate changes in endothelial cell density (ECD) in the corneal region after implantation of an iris-fixated phakic intraocular lens (PIOL).
Forty-five eyes of 25 myopic patients implanted with Artisan iris-fixated PIOLs (Ophtec BV) and 30 eyes of 15 myopic controls were enrolled. Corneal ECD and the distance between endothelium and the PIOL optic were evaluated in five different regions (central, nasal, superior, temporal, and inferior) using noncontact specular microscopy and rotating Scheimpflug imaging.
In PIOL-implanted patients, significant differences between the ECD in the superior region, compared with the lowest ECD in any region, and the ECD of the central region, compared with that of the region with highest ECD, were evident. When PIOL-implanted eyes were divided based on time since operation, a significant difference was observed only in patients for whom at least 48 postoperative months had elapsed. In untreated myopic controls, the greatest ECD was observed at the superior cornea. The distance between the central corneal endothelium and PIOL was significantly longer than that of the peripheral locations.
The extent of ECD decrease was not consistent throughout the cornea after implantation of an iris-fixated PIOL. Therefore, ECD measurement not only at the corneal center but also at midperipheral corneal locations, especially in the superior cornea, may be important in patients with irisfixated PIOLs.
评估虹膜固定型有晶状体眼人工晶状体（PIOL）植入后角膜区域内皮细胞密度（ECD）的变化。
共纳入 25 例（45 只眼）近视患者和 15 例（30 只眼）近视对照者，这些患者均植入了 Artisan 虹膜固定型 PIOL（Ophtec BV）。使用非接触式共焦显微镜和旋转式 Scheimpflug 成像，在五个不同区域（中央、鼻侧、上方、颞侧和下方）评估角膜 ECD 和内皮与 PIOL 光学区之间的距离。
在 PIOL 植入患者中，上方区域的 ECD 与任何区域中最低的 ECD 相比，以及中央区域的 ECD 与 ECD 最高的区域相比，差异均有统计学意义（P＜0.05）。当根据术后时间将 PIOL 植入眼进行分组时，仅在至少术后 48 个月的患者中观察到差异有统计学意义。在未经治疗的近视对照组中，角膜最上方的 ECD 最大。中央角膜内皮与 PIOL 之间的距离明显长于周边位置。
在虹膜固定型 PIOL 植入后，角膜ECD 的减少程度在整个角膜并不一致。因此，ECD 测量不仅在角膜中心，而且在中周边角膜位置，尤其是在上方角膜，对于虹膜固定型 PIOL 患者可能很重要。
