Dependency of endothelial cell loss on anterior chamber depth within first 4 years after implantation of iris-supported phakic intraocular lenses to treat high myopia.

PURPOSE: To evaluate the effect of the anterior chamber depth (ACD) on the central corneal endothelial cell density (ECD) in eyes after implantation of an iris-fixated phakic intraocular lens (pIOL). SETTING: Department of Ophthalmology, Goethe-University, Frankfurt, Germany. DESIGN: Retrospective nonrandomized case series. METHODS: An Artisan pIOL was implanted in eyes of highly myopic patients. Follow-up examinations at 1, 12, 24, 36, and 48 months included evaluation of ECD and adverse events. Three cohorts based on the ACD were established and their ECDs compared. All eyes had 1-year and 4-year postoperative ECD measurements available. Statistical analysis included linear regression analysis to evaluate the influence of ACD on ECD. RESULTS: The study comprised 95 eyes (52 patients). Four years after surgery the mean spherical equivalent changed from -11.06 diopters (D) ± 4.77 (SD) to -0.42 ± 0.47 D. Severe adverse events were not detected. There was a significantly higher ECD loss after 4 years in patients with an ACD of less than 3.00 mm than in those with an ACD greater than 3.40 mm (-224 cells/mm2) (P < .01). There was no significant difference in ECD between eyes with an ACD of 3.00 to 3.39 mm and eyes with an ACD less than 3.00 mm (P = .23) or more than 3.40 mm (P = .08). CONCLUSIONS: The iris-claw pIOL precisely and safely corrected high myopia. However, the loss in ECD can be considerable. Establishing stricter exclusion criteria for ACD might reduce this loss. FINANCIAL DISCLOSURE: Proprietary or commercial disclosures are listed after the references.

Comparison of monocular and binocular infrared pupillometers under mesopic lighting conditions.

PURPOSE: To compare 3 infrared pupillometers under mesopic lighting conditions in refractive surgery candidates with moderate to high myopia. SETTING: Johann Wolfgang Goethe-University, Department of Ophthalmology, Frankfurt/Main, Germany. METHODS: In this prospective 1-day study, pupils of refractive surgery candidates with moderate to high myopia were measured with 3 infrared pupillometers: the monocular Colvard (monocular pupillometer A), the monocular PupilScan II (monocular pupillometer B), and the binocular Procyon P2000SA. Mesopic lighting conditions were consistent with the International Organization for Standardization for phakic intraocular lenses and manufacturer instructions as follows: 3 cd/m(2) (both monocular pupillometers), 0.4 lux (binocular pupillometer mesopic low setting), and user defined (binocular pupillometer user setting). Pupil diameters were measured twice per pupillometer by 2 independent examiners. RESULTS: The study included 40 subjects (80 eyes). The mean pupil diameters were similar except with the mesopic low setting of the binocular pupillometer, which measured pupil diameter approximately 1.2 mm smaller. There was a high correlation between the 2 monocular pupillometers (0.83, P<.0001). The correlation between the monocular methods was stronger than that between the binocular user setting and either monocular method (monocular pupillometer A, r(2) = 0.665, P<.0001; monocular pupillometer B, r(2) = 0.594, P<.0001). No statistically significant difference was found between monocular pupillometer A, monocular pupillometer B, and the binocular pupillometer user setting. CONCLUSION: Both monocular pupillometers and the binocular pupillometer user setting measured pupil diameter under mesopic conditions similarly in eyes with moderate to high myopia.