Effect of intraoperative manipulation during iris-claw phakic IOL implantation on endothelium

Objective: To evaluate the effect of intraoperative complications during iris-claw phakic intraocular lens (pIOL) implantation on endothelial cell survival. Design: Retrospective cohort study. Participants: Fifty-two eyes of 26 patients with high myopia treated with the iris-claw pIOL. Methods: The patients were divided as group 1 (no intraoperative events) and 2 (intraoperative events) according to the intraoperative events such as intraoperative bleeding, postoperative intraocular pressure (IOP) rise, and late resolution of the chamber inflammation. Endothelial cell density was compared at 1, 2, 6, 12, and 24 months after the operation prospectively. Results: Group 1 showed mean percentage of individual change of -0.04% plusmn; 7.90% at 1 month, -0.01% plusmn; 8.67% at 2 months, -0.02% plusmn; 10.33% at 6 months, 0.05% plusmn; 9.81% at 12 months, and 0.05% plusmn; 5.33% at 24 months postoperatively. In group 2, mean percentage individual cell change was -0.17% plusmn; 8.57% at 1 month, -0.13% plusmn; 12.14% at 2 months, -0.13% plusmn; 15.07% at 6 months, -0.17% plusmn; 11.94% at 12 months, and -0.28% plusmn; 13.54% at 24 months postoperatively. Two groups showed a significant differences in every visit. Conclusions: Even transient events, such as intraoperative bleeding, postoperative IOP rise, and late resolution of the chamber inflammation, would affect the survival of endothelial cells.