University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Netherlands.
University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, Netherlands.
Am J Ophthalmol. 2018 Oct;194:110-119. doi: 10.1016/j.ajo.2018.07.015. Epub 2018 Jul 24.
To evaluate the long-term changes in endothelial cell density (ECD) after the implantation of 2 types of foldable iris-fixated phakic intraocular lenses (pIOLs) for the treatment of myopia and astigmatism.
Prospective clinical cohort study.
Two-hundred and ninety-three and 188 eyes implanted with, respectively, the Artiflex Myopia and Artiflex Toric (Ophtec B.V., Groningen, The Netherlands) iris-fixated pIOL for the treatment of myopia or astigmatism at the University Eye Clinic Maastricht as of January 2004. One-hundred and forty-six eyes from the myopic and 64 eyes from the toric groups completed a 5-year follow-up. Main outcome measures were chronic endothelial cell (EC) loss, percentage of eyes with a ≥25% decrease in ECD, and the percentage of eyes with an ECD < 1500 cells/mm.
Chronic EC loss showed an annual decline of 64 cells/mm in the myopic (P < .001, standard error 3.58) and 62 cells/mm in the toric (P < .001, standard error 3.77) groups. Total chronic EC loss from 6 months to 5 years postoperatively was 10.5% in the myopic and 10.2% in the toric groups. After 5 years, an ECD decrease of ≥25% occurred in 4.4% and 4.3% of eyes, and an ECD < 1500 cells/mm was reported in 3.0% and 0.0% of eyes, respectively. Explantation of a pIOL owing to EC loss was required in 3.1% and 0% of eyes.
Chronic EC loss was around 10% over a 5-year period in eyes implanted with the foldable myopic (toric) pIOL. In up to 3.1% of eyes significant EC loss resulted in subsequent pIOL explantation.
评估 2 种折叠式虹膜固定型有晶状体眼人工晶状体（pIOL）植入治疗近视和散光后内皮细胞密度（ECD）的长期变化。
前瞻性临床队列研究。
2004 年 1 月，在马斯特里赫特大学眼科诊所，分别使用 Artiflex Myopia 和 Artiflex Toric（荷兰格罗宁根 Ophtec B.V.）虹膜固定型 pIOL 治疗近视或散光的 293 只眼和 188 只眼。近视组 146 只眼和散光组 64 只眼完成了 5 年随访。主要观察指标为慢性内皮细胞（EC）丢失、ECD 下降≥25%的眼比例以及 ECD<1500 个细胞/mm 的眼比例。
近视组慢性 EC 丢失每年下降 64 个细胞/mm（P<0.001，标准误差 3.58），散光组下降 62 个细胞/mm（P<0.001，标准误差 3.77）。术后 6 个月至 5 年总慢性 EC 丢失分别为近视组 10.5%和散光组 10.2%。5 年后，ECD 下降≥25%的眼分别为 4.4%和 4.3%，ECD<1500 个细胞/mm 的眼分别为 3.0%和 0.0%。因 EC 丢失需要取出 pIOL 的眼分别为 3.1%和 0%。
植入折叠式近视（散光）pIOL 的眼在 5 年内慢性 EC 丢失约为 10%。在多达 3.1%的眼中，大量 EC 丢失导致随后需要取出 pIOL。
