CORNEAL ENDOTHELIAL-CELL DAMAGE FROM PHAKIC ANTERIOR-CHAMBER INTRAOCULAR-LENS FOR MYOPIA, DURING THE 1ST YEAR

We conducted a prospective study of the corneal endothelium of 31 severely myopic eyes (17 patients) corrected by phakic anterior chamber intraocular lens. Patients were examined 3 months, 6 months and 12 months after surgical operation. In the center of the cornea, we noted a mean cell loss of 5.3% (p = 0.03) at 3 months, 8,2% (p < 0.001) at 6 months and 15.5% at 12 months. The maximal cell loss was 21.6% at 3 months, 29% at 6 months and 58% at 12 months. The loss between 6 and 12 months was significant (p O0.01). In the periphery, the endothelial density was slightly lower than the central density (mean: 3.2%). In some cases, we saw areas of cellular denuding, It appeared that endothelial cell loss can be very different in the two eyes of the same patient, as well as between two different patients. Our study showed that the reduction of endothelial cell density was progressive with time. Intermittent contact between the implant and corneal endothelium was highly suspected, but this mechanism may not be the only one involved. The future integrity of these corneas is at stake and the problem of explantation of some implants is beginning to be a real one.