Cesk Slov Oftalmol. 2022 Summer;78(4):188-195. doi: 10.31348/2022/21.
To determine the changes in endothelial cell density, refractive results, and risk factors associated with endothelial loss in patients with irisclaw phakic intraocular lenses for myopia/myopic astigmatism (Artisan).
Data collection was obtained from an existing database with information on patients with a phakic Artisan lens implant between 1998 and 2011 at the Virgilio Galvis Ophthalmology Centre, with at least 5 years of follow-up. As a second stage, an analysis was carried out to identify the change in endothelial cell density and its potential associated factors.
A total of 80 eyes with myopic errors were included with a follow-up of 11.9 + 3.48 years. The percentage of total loss of endothelial cells was greater than 25% of the preoperative density in 43.8% of the eyes. A postoperative annual loss > 1.6% was found in 47.0% of the eyes with that information available. 41 eyes (51%) had final endothelial density < 2000 cells/mm2, and 7 (8.8%) eyes had endothelial cell density < 1000 cells/mm2. Among the variables studied, no associated factors for long-term endothelial loss were found. During the course of the study, 8 (10%) phakic intraocular lenses were explanted, including 3 with accelerated endothelial loss, and another 2 with cataract associated and a significantly low endothelial density. The last mean spherical equivalent was -0.81 (±1.01 D), and the final uncorrected distance visual acuity was 0.45 logMar (Snellen 20/56).
Artisan-type phakic lenses are a good alternative for the correction of high myopic defects, with predictable refractive results in the long term. However, there is an increased loss of endothelial cells in the long term in a high percentage of patients. Strict postoperative follow-up, including endothelial evaluation, is required, and further studies are warranted.
确定用于近视/近视散光的虹膜扣 Phakic 眼内透镜（Artisan）患者的内皮细胞密度变化、屈光结果以及与内皮丢失相关的危险因素。
数据收集来自于 1998 年至 2011 年在 Virgilio Galvis 眼科中心接受 Phakic Artisan 透镜植入术的患者的现有数据库，这些患者的随访时间至少为 5 年。作为第二阶段，进行了分析以确定内皮细胞密度的变化及其潜在的相关因素。
共纳入 80 只眼，近视误差，随访 11.9 + 3.48 年。在 43.8%的眼中，总内皮细胞丧失率超过术前密度的 25%。在有信息可查的 47.0%的眼中，发现术后每年损失 > 1.6%。41 只眼（51%）最终内皮密度 < 2000 个细胞/mm2，7 只眼（8.8%）内皮细胞密度 < 1000 个细胞/mm2。在所研究的变量中，未发现与长期内皮丢失相关的因素。在研究过程中，有 8 只（10%）Phakic IOL 被取出，其中 3 只与加速的内皮丢失有关，另外 2 只与白内障相关，内皮密度明显较低。最后平均球镜等效值为-0.81（±1.01 D），最终未矫正的远距离视力为 0.45 logMar（Snellen 20/56）。
Artisan 型 Phakic 透镜是矫正高度近视缺陷的一种良好选择，长期预测屈光效果良好。然而，在很大一部分患者中，内皮细胞会长期大量丢失。需要进行严格的术后随访，包括内皮评估，还需要进一步的研究。
