Long-term follow-up of endothelial cell loss after implantation of collamer posterior chamber intraocular lenses

Resumen

PURPOSE: To assess long-term endothelial cell density (ECD) changes in eyes undergoing Implantable Collamer Lens (ICL, STAAR surgical, Nidau, Switzerland) surgery for the correction of moderate to high levels of anisometropia. SETTING: Fernández-Vega Ophthalmological Institute, Oviedo, Spain. METHODS: This study involved 36 eyes of 36 patients who received unilateral V4 ICL implantation to correct anisometropia. Mean age of the patients at the time of surgery was 33.78 ± 6.99 years (range: 24 to 49 years) and mean manifest spherical equivalent (SE) was −13.65 ± 5.40 diopters (D; range: −25.25 to −0.75 D). Mean follow-up after  ICL implantation was 7.4 years (range: 4 to 10 years). The Specular Microscope SP-3000P (Topcon, Europe) was used to measure ECD in operated and non-operated eyes after the follow-up period. RESULTS: Mean ECD decreased significantly from 2803 ± 423 cells/mm² preoperatively to 2,580 ± 357 cells/mm² after surgery. Endothelial cell loss between the preoperative evaluation and at 7.4 years was 10.8 ± 18.6% in operated eyes. Mean ECD was also seen to decrease from 2,690 ± 440 cells/mm² t baseline to 2,628 ± 400 cells/mm² after 7.4 years in the non-operated eyes, although these changes were not statistically significant. Thus, endothelial cell loss due to ICL surgery was 7.7% after 7.4 years of follow-up. CONCLUSIONS: Despite significant endothelial cell loss throughout the follow-up period, ICL implantation is a safe procedure for correcting low to high anisometropia. The outcomes also showed endothelial cell loss in the non-operated eyes over the follow-up period, but this finding could be attributed to natural physiological changes and aging.