Abstract:

Objective To observe the long-term changes of corneal endothelial cell density after Phakic 6H anterior chamber Phakic intraocular lens (ACP-IOL) implantation for the correction of high myopia, and evaluate the safety of the surgical procedure. Methods One hundred and seventy patients (283 eyes) undergoing Phakic 6H ACP-IOL implantation for the correction of high myopia between September 2001 and March 2006 were collected and followed up, and the data of 7 patients (7 eyes) with ACP-IOL removal ultimately were retrospectively analysed. The corneal endothelial cell density of central, upper, lower, temporal and nasal parts of cornea was measured by SP-2000P corneal endothelial endoscopy. Results These 7 patients were followed up for an average of 5 years, with an average corneal endothelium loss of 2 105 cells/mm² and average loss rate of 73.71% in 6 eyes (measurement could not be performed in 1 eye due to corneal endothelium decompensation). The combined procedures of ACP-IOL removal, clear crystalline lens extraction and posterior chamber intraocular lens (IOL) implantation were performed in 4 eyes, ACP-IOL removal, phacoemulsification and posterior chamber IOL implantation in 1 eye, and ACP-IOL removal in 2 eyes. Conclusion Phakic 6H ACP-IOL can lead to critical corneal decompensation and even corneal decompensation in a long term. ACP-IOL must be removed as soon as the corneal endothelium function is in a state of critical decompensation or the endothelium is significantly damaged.

Key words: Phakic, intraocular lens implantation, high myopia, corneal endothelial cell density