准分子激光角膜切削术后屈光度过桥的临床分析

目的 探讨ＰＲＫ术后屈光度过矫的原因。方法 报告ＰＲＫ术后屈光度过桥４例（６眼），男性１例（２眼），女性３例（４眼）。结果 术前近视屈光度－３．０￣－６．０Ｄ，术后过矫屈光度＋１．２５￣３．７５Ｄ。随访６￣１２个月。有５眼随着角膜厚度的增加，角膜表面平均屈力的提高，过矫屈光度减小，裸眼视力提高至预期值，１眼无变化。结论 认为利用ＰＲＫ术后角膜上皮及胶原组织增生致远期屈光回退，通过密切监测角膜厚度、     

准分子激光角膜切削术后屈光回退伴角膜雾浊再次手术疗效

近视眼准分子激光角膜切削术（ｐｈｏｔｏｒｅ－ｆｒａｃｔｌｖｅｋｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）后，部分病例存在远期屈光回退、角膜雾浊（Ｈａｚｅ）影响疗效。我院ＰＲＫ中心于１９９６年８月～１９９７年２月对６例８眼ＰＲＫ术后屈光回退伴角膜Ｈａｚｅ病例行再次ＰＲＫ治疗，效果满意，总结报道如下。１材料与方法１．１临床资料８眼病例为我院ＰＲＫ中心治疗后随访１１．２±１．４ｍｏ出现屈光回退伴角膜Ｈａｚｅ的近视眼患者，男６眼，女２眼，年龄２４．０±４．０６ａ（１９～４０ａ）。首次ＰＲＫ术前平均等值球镜屈光度为一…     

苏式放射状角膜切开术后2年疗效评价

报道苏式放射状角膜切开术后２年以上资料完整的１５７例（３１４眼）的疗效。术前裸眼视力平均０．１６，手术切口４－１２刀，视区３．０－３．２ｍｍ。术后２年视力平均０．７，１．０以上２１９眼占７０％，０．５以上２８４眼占９０．４５％。中度近视组术后屈光度平均下降４．６２Ｄ，高度近视组平均下降６．２９Ｄ，最高度近视组平均下降７．２５Ｄ；术后散光平均值增加，角膜曲率明显减低。结果表明苏式放射状角膜切开术治疗近视眼疗效显著，术后屈光度稳定。分析影响ＲＫ术疗效的因素，报道本组病例术中术后的并发症，分析发生并发症的原因提出有关预防及处理措施。     

应用角膜地形图评价PRK矫正近视散光的疗效

目的以ＰＲＫ矫正近视性散光术后１ａ临床结果和角膜地形图检测结果评价ＰＲＫ矫正近视散光的效果。方法对６１只眼近视散光在－２．００Ｄ以上者应用ＰＲＫ治疗，术后随访１ａ，并对手术前后散光的变化进行角膜地形图比较。结果患者ＰＲＫ术后１ａ检查，其中６０只眼散光在０～－１．００Ｄ之间，角膜切削区中心距瞳孔中心均≤０．５ｍｍ，角膜地形图检测术前△Ｋ值为１．８５±０．５９Ｄ，术后△Ｋ值为０．９０±０．４３Ｄ，显示术后散光下降明显。结论ＰＲＫ治疗散光效果明显，但应解决角膜切削区域偏中心情况。     

白内障合并真性囊膜剥脱综合征手术方式探讨

目的　探讨手术治疗白内障合并真性囊膜剥脱综合征的安全性。方法　回顾性分析２０１０年３月至２０１５年１月期间在河北省眼科医院白内障科就诊的白内障合并真性囊膜剥脱综合征患者４例（５眼）,其中３眼悬韧带正常,我们在撕囊和正常超声乳化手术过程中未发现任何异常;另外２眼合并晶状体不全脱位,我们使用４个虹膜拉勾固定囊袋,囊袋内预劈技术将晶状体核劈成８块,扭动超声乳化核及吸除皮质后,囊袋内植入张力环及人工晶状体。比较术前及术后最佳矫正视力、超声乳化总时间、灌注液消耗量、角膜中央内皮细胞密度、角膜内皮细胞丢失率,观察囊袋及人工晶状体有无偏心移位以及并发症的发生情况。结果　术后３个月最佳矫正视力０．８者２眼,０．６者１眼,０．５者２眼,术后３个月最佳矫正视力均较术前增加。晶状体超声乳化时间为３０．２～５２．６（４５．４±９．１）ｓ。灌注液消耗量为６３．１８～８０．２６（７１．９７±６．９４）ｍＬ。术前角膜中央内皮细胞密度２１６３～２８９２（２５０５．２±３１７．４）ｍｍ－２,术后３个月为２０７５～３０２３（２４１５．４±３０８．１）ｍｍ－２。角膜内皮细胞丢失率为３．５９％。术后５眼测得人工晶状体偏中心量为０．１２～０．４６（０．３０±０．１５）ｍｍ。５眼人工晶状体均成功植入囊袋内,术中未出现后囊膜破裂、悬韧带损伤或加重,术后第１天角膜均透明,远期未出现囊袋收缩、后囊膜混浊等并发症。结论　采用囊袋内预劈核联合虹膜拉勾囊袋固定和囊袋内植入张力环,可以增加合并真性囊膜剥脱综合征白内障手术的安全性。     

PRK切削中心偏离的临床观察

为研究准分子激光屈光性角膜切削术（ＰｈｏｔｏｒｅｆｒａｃｔｉｖｅＫｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）切削中心偏离对角膜散光与欠矫的影响。对ＰＲＫ术后２１０眼行角膜地形图检查后发现，ＰＲＫ切削偏心小于０５０ｍｍ者为３７２％，０５０～１００ｍｍ者为５３３％，１０ｍｍ以上者为９５％，切削偏心平均为０７６ｍｍ，欠矫平均为１４１Ｄ，散光无明显改变。切削偏心能直接导致欠矫的发生，但对角膜散光无明显影响，减小偏心可以避免欠矫的发生。     

超声乳化白内障摘除术的角膜内皮细胞观察

用角膜内皮细胞分析仪对５８例（６９眼）超声乳化白内障摘除术行内皮细胞观察。手术前和术后３－６月的内皮细胞密度分别为２５８１．９±３４３．２个／ｍｍ２和２２７４．６±４０６．７个／ｍｍ２，细胞丧失率为１１．９％。平均细胞面积分别为３４２．１８±１３９．２１μｍ２和３９３．０３±２０３．４５μｍ２，变异系数分别为４０．６８％和５１．７％，六角形细胞比率分别为５５．３±１３．６％和４６．４±１７．１％，均有显著性差异。角膜厚度分别为５６１．８±３６．７μｍ和５７０．１±３４．４μｍ，无显著性差异。术后矫正视力０．５以上者占８９．７％，１．０以上者占６１．８％。     

微型角膜刀板层角膜成形联合准分子激光角膜切削术治疗高度近视

为评价微型角膜刀板层角膜成形联合准分子激光角膜切削术（ＭＬＫ－Ｅ或ＬＡＳＬＫ）治疗高度近视的效果和安全性，利用微型角膜刀作一带蒂角膜瓣，在其下用ｓｃｈｗｉｎｄＫｅｒａｔｏｍⅠ型准分子激光机进行ＰＲＫ激光切削，共治疗了３０例４７眼，术前屈光状态＜－１５Ｄ的Ⅰ组共３５眼，屈光度为－１０．２０±２．０４Ｄ，最佳矫正视力为０．９２±０．２６（０．４—１．５）；等球镜≥－１５Ｄ的Ⅱ组共１２眼，屈光度平均为－１７．６４±１．８３Ｄ，最佳矫正视力为０．４２±０．２３（０．１—０．８）。散光最高为４．５Ｄ。结果：术后３个月随访：Ⅰ组：屈光度平均为－０．４８±０．５２Ｄ（－１．７５—＋０．５０Ｄ），裸眼视力３４眼（９７％）达到０．５以上（另１眼裸眼视力等于术前），２５眼（７１．４％）裸眼视力达到术前最佳矫正视力。Ⅱ组：屈光度平均为－１．４４±１．９７Ｄ（－５．５０—＋１．２５Ｄ），８眼（６６．７％）裸眼视力达到术前最佳矫正视力。是一种安全有效的高度近视治疗方法。     

准分子激光屈光性角膜切削术术后角膜愈合的组织学定量研究

目的：定量描述准分子浙江屈光性角膜切削术（ＰＲＫ）术后早期角膜愈合的组织学变化规律。方法：２０只（４０只眼）新西兰白兔,行－５．０Ｄ ＰＲＫ手术。于术后３天、１周、２周、３周和４周观察角膜的组织学改变,并通过计算机图像处理系统,对其定量化。同时用苦味酸天狼星红偏振光法观察角膜胶原变化。结果：ＰＲＫ术后２周内上皮增生速度较快,２￣４周时,速度缓慢。基质内成纤维细胞密度于术后１周呈持续性增长。ＰＲＫ术     

LASIK术后角膜三维形态的改变及与临床屈光度的关系

目的应用裂隙扫描角膜地形图／角膜测厚系统（Ｏｒｂｓｃａｎ）评估高度近视眼ＬＡＳＩＫ术后角膜三维形态的改变以及探讨角膜屈光力改变和屈光度矫正之间的关系。方法选择行ＬＡＳＩＫ手术的高度近视眼４７例９１眼，应用Ｏｒｂｓｃａｎ系统进行术前、术后３月的角膜形态观察，分析角膜屈光力改变与眼球总体屈光力变化的相关性。结果高度近视眼前表面３　ｍｍ区平均曲率为４８．４９　Ｄ±１．２５　Ｄ，后表面３　ｍｍ区为－６．５　Ｄ±０．２３　Ｄ。术后３月平均矫正屈光度为６．６２　Ｄ±２．２１　Ｄ，前表面３　ｍｍ区平均曲率为４３．０２　Ｄ±１．２５　Ｄ，后表面３　ｍｍ区为－６．９　Ｄ±０．２４　Ｄ，与术前比较有显著性意义（Ｐ＜０．０５）。术后５　ｍｍ区与３　ｍｍ区的角膜屈光力差值明显比术前增大，差异有显著性意义（Ｐ＜０．０１）。术后角膜总屈光力改变平均值为５．８７　Ｄ±１．２１　Ｄ，与术后眼总体屈光力改变存在显著正相关（ｒ＝０．９５７　１，Ｐ＜０．０１）。结论Ｏｒｂｓｃａｎ能全面评估角膜屈光手术后三维形态的改变，对角膜屈光手术后白内障患者正确选择人工晶状体度数具有指导意义。     

Effect of mitomycin C on the corneal endothelium when used for corneal subepithelial haze prophylaxis following photorefractive keratectomy

PURPOSE: To evaluate the potential effect of topical mitomycin C (MMC) on the corneal endothelium of myopic patients undergoing photorefractive keratectomy (PRK). METHODS: Sixteen eyes with a planned ablation depth >75 microm underwent PRK followed by 0.02% MMC applied for 12 seconds using a methylcellulose sponge. Endothelial specular microscopy was performed with the Keeler-Konan specular photomicroscope in 16 eyes before and at least 1 year after surgery. Mean follow-up was 18 months (range: 12 to 24 months). Mean cell density, coefficient of variation of mean cell area, and percentage of hexagonal cells were measured and calculated using computerized morphometric analysis. RESULTS: Mean endothelial cell densities before and after surgery were 2882 +/- 783 cells/mm2 (range: 1511 to 4022 cells/mm2) and 2867 +/- 588 cells/mm2 (range: 1638 to 3881 cells/mm2), respectively (P > .05). Mean coefficient of variation before and after surgery was 0.30 +/- 0.07 (range: 0.23 to 0.49) and 0.26 +/- 0.04 (range: 0.22 to 0.33), respectively (P=.06). Mean percentage of hexagonal cells before and after surgery was 61% +/- 6.8% (range: 47% to 70%) and 66% +/- 6.7% (range: 54% to 75%), respectively. CONCLUSIONS: Administration of MMC for haze prophylaxis following PRK did not have a significant effect on quantitative endothelial cell density or qualitative morphometric parameters in this study.     

Photorefractive keratectomy with mitomycin C after deep anterior lamellar keratoplasty for keratoconus

PURPOSE: To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with intraoperative mitomycin C (MMC) after deep anterior lamellar keratoplasty (DALK) for keratoconus. METHODS: This was a prospective, noncomparative single-surgeon study. Eyes with compound myopic astigmatism after DALK with a spherical equivalent (SE) between -3 and -10 D were treated by PRK. After ablation, MMC 0.2 mg/mL was placed on the stromal bed for 45 seconds. A 6% undercorrection was planned. RESULTS: The study was completed on 10 eyes of 10 patients. The preoperative mean SE was -4.98 +/- 1.75 (SD) D. At 10 months after surgery, the mean SE was 0.28 +/- 0.61 D, and the mean defocus equivalent was 1.08 +/- 0.58 D. Postoperatively, 9 eyes were within 2 D, 6 were within 1 D, and 1 eye was within 0.5 D of defocus equivalent. The preoperative mean best spectacle-corrected visual acuity (BSCVA) was 0.68 +/- 0.15 D, and at 10 months it was 0.78 +/- 0.13 D. The 95% confidence interval for the mean difference of pre- and postoperative BSCVA was 0.02-0.17 (P < 0.05). No lines of BSCVA were lost. The mean postoperative uncorrected visual acuity was 0.55 +/- 0.1. The safety index was 1.15, and the efficacy index was 0.81. Corneal haze was grade 0 in 8 eyes and grade 0.5 in 2 eyes. Mean epithelialization time was 4.1 +/- 0.99 days. Preoperative mean endothelial cell density was 2320 +/- 184 cells/mm(2), and at 10 months it was 2284 +/- 175 cells/mm(2). CONCLUSIONS: PRK with MMC can safely and effectively correct myopia and regular myopic astigmatism after DALK. Undercorrection should be planned to compensate for the overcorrecting effect of MMC.     

Alterations in endothelial cell density after photorefractive keratectomy with adjuvant mitomycin

PURPOSE: To elucidate the distinct role of the intraoperative use of mitomycin C (MMC) on endothelial cell density after photorefractive keratectomy (PRK) in human eyes. DESIGN: Prospective, double-masked, randomized clinical trial. METHODS: One eye of 15 patients was treated with PRK with intraoperative use of topical 0.02% MMC (15 seconds), whereas the fellow eye was treated with Epipolis laser in situ keratomileusis (Epi-LASIK) in random order. Corneal confocal microscopy was performed in all eyes preoperatively and at one, three, six, and 12 months after the surgery. Moreover, three endothelial images were acquired in each of 15 preoperative-normal eyes to evaluate the repeatability of measuring endothelial cell density. Repeated measures analysis of variance was used to compare the temporal variations of endothelial cell density between the two techniques and the changes of endothelial cell density over time. RESULTS: The coefficient of repeatability of endothelial cell count was 148 cells/mm(2). Preoperative endothelial cell density was not significantly different between the two groups (P = .82). Moreover, the effect of the treatment on the temporal variation of endothelial cell density was insignificant (P = .83), whereas the differences between the preoperative and the postoperative endothelial cell densities reached statistical significance (P .05). CONCLUSIONS: The prophylactic intraoperative application of MMC (up to 15 seconds) after PRK does not seem to affect the endothelial cell density.     

Endothelial cell density after photorefractive keratectomy for moderate myopia using a 213 nm solid-state laser system

PURPOSE: To evaluate whether photorefractive keratectomy (PRK) for moderate myopia using a solid-state laser with a wavelength of 213 nm alters the corneal endothelial cell density. SETTING: University refractive surgery center. METHODS: The corneal endothelium was analyzed preoperatively and 1, 6, and 12 months postoperatively using corneal confocal microscopy (modified HRT II with a Rostock Cornea Module, Heidelberg Engineering) in 60 eyes (30 patients). Patients were randomized to have myopic PRK using a 213 nm wavelength solid-state laser (study group) or a conventional 193 nm wavelength excimer laser (control group). Three endothelial images were acquired in each of 30 preoperative normal eyes to evaluate the repeatability of endothelial cell density measurements. Repeated-measures analysis of variance was used to compare the variations in endothelial cell density between the 2 lasers and the changes in endothelial cell density over time. RESULTS: There were no statistically significant differences in sex, age, corneal pachymetry, attempted correction, preoperative endothelial cell density, or postoperative refractive outcomes (uncorrected visual acuity, best spectacle-corrected visual acuity, and spherical equivalent refraction) between the 2 groups (P>.05). The coefficient of repeatability of endothelial cell density was 131 cells/mm(2). The measured endothelial cell count per 1.0 mm(2) did not significantly change up to 1 year postoperatively in either group (both P>.05). No statistically significant difference was found between the 2 groups in any postoperative interval (P>.05). CONCLUSION: Photorefractive keratectomy for moderate myopia using a 213 nm wavelength solid-state laser or a conventional 193 nm wavelength excimer laser did not significantly affect corneal endothelial density during the 1-year postoperative period.     

Endothelial cell loss after toric iris-fixated phakic intraocular lens implantation: three-year follow-up

PURPOSE: To study quantitative changes in endothelial cell count after implantation of the toric iris-fixated phakic intraocular lens. METHODS: A prospective, non-randomized, self-controlled clinical trial was conducted of 40 eyes (28 myopic, 12 hyperopic) of 23 patients with high ametropia and astigmatism. Non-contact computer-assisted endothelial microscopy was performed before and 1, 2, and 3 years after surgery. RESULTS: In the myopic group, mean preoperative endothelial cell count was 3179 +/- 531 cells/mm2 (range: 1800 to 3900 cells/mm2). The mean intra-individual endothelial cell loss was -1.83 +/- 2.25% (range: -9.09% to 0%) in the first year; -1.83 +/- 2.95% (range: -7.74% to 3.80%) in the second year; and -3.20 +/- 4.43% (range: -14.25% to 1.91%) three years after surgery, compared to preoperative values. In the hyperopic group, mean preoperative endothelial cell count was 3107 +/- 125 cells/mm2 (range: 2932 to 3300 cells/mm2). The mean endothelial cell loss was -1.63 +/- 1.76% (range: -3.23% to 1.67%) in the first year; -0.05 +/- 1.25% (range: -1.65% to 1.75%) in the second year; and -2.88 +/- 2.03% (range: -5.33% to -0.13%) three years after surgery, compared to preoperative values. CONCLUSIONS: Annual cumulative cell loss was -1.9% for the myopic group and -1.6% for the hyperopic group, which is two to three times greater than physiological annual cell loss in normal eyes without surgery. An annual endothelial cell count analysis is highly recommended in every patient after iris-claw lens implantation to detect potential progressive cell loss at an early stage.     

Initial results of endothelial cell counts after Artisan lens for phakic eyes: an evaluation of the United States Food and Drug Administration Ophtec Study

PURPOSE: To evaluate the endothelial cell count change in eyes implanted with the iris-claw phakic Artisan lens for treatment of moderate to high myopia. DESIGN: Prospective, multicenter clinical trial. PARTICIPANTS: The first 765 eyes enrolled at 25 North American sites in the United States Food and Drug Administration Ophtec clinical trial of the myopic Artisan IOL. Outcome analyses of endothelial cell count measurements were based on those obtained before surgery and at 6, 12, and 24 months after surgery performed between October 1998 and December 2001. SETTING: Multiple private and university practices. METHODS: Percentage change in endothelial cell count from baseline to 6, 12, and 24 months were analyzed using specular microscopy. Upper limit of detecting endothelial cell density change was estimated using 3 repeated counts at preoperative and postoperative time frames. MAIN OUTCOME MEASURES: Percentage change in endothelial cell loss. RESULTS: The mean preoperative endothelial cell count was 2631+/-442 cells/mm(2). Percentage change from baseline at 6, 12, and 24 months was -0.09%+/-16.39%, -0.87%+/-16.35%, and -0.78%+/-17.41%. No statistically significative postoperative endothelial cell loss was found. The endothelial cell loss rate was higher among patients who wore spectacles before surgery and was correlated negatively with preoperative endothelial cell density (P<0.001). No relationships were noted between endothelial cell loss and either patient age or implant power. A 4.1% repeatability of measurements was found based on the average of 3 repeated counts, whereas single cell count estimates were associated with a 23% accuracy in detecting endothelial cell density change. In a worst-case scenario, adjusting for measurement accuracy, 9% of all eyes were at higher risk of a 10% loss of cell density at 12 months after surgery, although eyes at higher risk were found to have high preoperative endothelial cell counts (P<0.0001). CONCLUSIONS: The Artisan iris-claw phakic intraocular lens did not result in significant loss of endothelial cell density up to 2 years after implantation of the myopic Artisan phakic lens.     

Prospective randomized study of corneal aberrations 1 year after radial keratotomy or photorefractive keratectomy

PURPOSE: To evaluate the optical properties of the cornea 1 year after either radial keratotomy (RK) or photorefractive keratectomy (PRK) in a randomized group of patients with low myopia. METHODS: Ninety-six patients with myopia between -0.75 and -5.00 D were randomized to either radial keratotomy (n = 46) or photorefractive keratectomy (n = 50). Topography maps were obtained 1 year after surgery and analyzed by computation of total corneal wavefront aberration and Zernike polynomial coefficients for pupil sizes of 2, 4, and 6 mm. The 4-mm pupil size was used for optimization of the model. RESULTS: The total corneal wavefront aberrations after RK and PRK were similar and not statistically different. Wavefront aberrations arising from astigmatism or defocus accounted for approximately 70% of the total wavefront error at all pupil sizes in both groups. All types of aberrations, and in particular spherical aberration, increased significantly with increasing pupil size. Higher-order wavefront aberrations were almost twice as high after RK than after PRK at pupil sizes of 4 and 6 mm. Spherical aberration and coma were slightly higher after PRK than after RK. CONCLUSIONS: Pupil size had a major effect on corneal aberrations after RK and PRK. The most important aberrations were sphero-cylindrical, in which eyes became significantly more myopic with increasing pupil size. The image forming properties of the cornea are better after PRK compared with RK due to the lesser amount of higher-order aberrations.     

Long term changes in human corneal endothelium following toxic endothelial cell destruction: a specular microscopic and fluorophotometric study.

AIMS: To investigate the long term relation between corneal thickness, endothelial morphometric variables, and endothelial permeability in patients with endothelial cell counts under 900 cells/mm2 as a result of endothelial cell destruction after cataract surgery. METHODS: Eighteen patients developed the so called toxic endothelial cell destruction (TECD) syndrome following routine cataract surgery because of the intracameral injection of a toxic detergent residue. Ten patients with a mean (SEM) initial cell loss of 72% (2%) were followed for 4 years. Data were obtained at 6 months and 4 years postoperatively and compared between TECD eyes and contralateral control eyes. RESULTS: Mean (SEM) endothelial cell density of the TECD eyes increased from 642 (41) cells/mm2 to 849 (50) cells/mm2 at 4 years postoperatively (p = 0.005). There was no difference in coefficient of variation or percentage hexagonals between 6 months and 4 years postoperatively. Mean (SD) corneal thickness of the TECD eyes and control eyes was similar, 0.51 (0.02) mm and 0.49 (0.01) mm, respectively (p = 0.65). Mean (SD) endothelial permeability was also similar for TECD eyes and control eyes (4.3 (0.9) x 10(-4) cm/min and 4.4 (0.6) x 10(-4) cm/min, respectively (p = 0.57). There was no correlation between endothelial cell density, coefficient of variation, or percentage of hexagonal cells and endothelial permeability in the TECD eyes. In three patients a permanent corneal decompensation occurred. CONCLUSIONS: Four years after TECD corneal endothelial wound healing is stable and the barrier function has been restored.     

Two-year corneal endothelial cell assessment following INTACS implantation

PURPOSE: To evaluate the 2-year effects of intrastromal corneal ring segments (INTACS) on the corneal endothelium. METHODS: Non-contact specular microscopy was performed as a subgroup test in a Phase III clinical trial. Endothelial cell images were collected before surgery and at 6, 12, and 24 months after surgery at the central and peripheral (6 and 10 o'clock) regions. Images were recorded and analyzed later by a central reading center. Cell density, coefficient of variation, and percent hexagonal cells were determined. RESULTS: There were no clinically significant changes in the endothelial cell structure at 6, 12, and 24 months (102 eyes). There was a gain of 5 cells/mm2 (6 months) and 3 cells/mm2 (12 months) at the central region of the cornea and a loss of 28 cells/mm2 at 24 months. At the 6 o'clock region of the cornea, there was a loss of 0, 24, and 92 cells/mm2 at 6, 12, and 24 months. At the 10 o'clock region of the cornea, there was a loss of 14, 30, and 94 cells/mm2 at 6, 12, and 24 months. INTACS did not statistically affect the central cell density at 6 and 12 months, however, there was a slight loss centrally at 24 months. At 24 months, all corneal regions had a slight decrease in cell density. In all eyes, mean central and peripheral endothelial cell counts remained above 2495 cells/mm2. Coefficient of variation improved and percent hexagonal cells remained unchanged. CONCLUSION: Endothelial cell density changes at 2 years after INTACS implantation were not clinically significant and endothelial cell remodeling was present.     

Long-term endothelial cell loss after traumatic dislocation and repositioning of Artisan phakic IOL

PURPOSE: To evaluate long-term endothelial cell loss after traumatic dislocation and repositioning of an Artisan phakic intraocular lens (PIOL). METHODS: Traumatic PIOL dislocation occurred in the patient's left eye 4 months after uneventful implantation for unilateral congenital myopia. Using the Konan semi-automated analysis method, endothelial cell density was measured preoperatively, before Artisan repositioning, and 1, 2, and 4 years after primary implantation. RESULTS: Endothelial cell density was 2770 cells/mm2 preoperatively and 2634 cells/mm2 before Artisan repositioning. After successful repositioning, endothelial cell density progressively decreased--1, 2, and 4 years from primary implantation, endothelial cell density was 2582, 2524, and 2538 cells/mm2, respectively, corresponding to losses of 6.8%, 8.9%, and 8.4%, respectively. CONCLUSIONS: Progressive and long-term endothelial loss after traumatic dislocation and repositioning of the Artisan PIOL may be comparable to that reported after uneventful implantation.