J Korean Ophthalmol Soc.  2015 May;56(5):784-788. 10.3341/jkos.2015.56.5.784.

Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report

Affiliations
  • 1Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. crisim@korea.ac.kr

Abstract

PURPOSE
To report a case of decreased endothelial cell density 7 years after posterior chamber phakic intraocular lens implantation.
CASE SUMMARY
A 45-year-old man with high myopia combined with astigmatism was treated with Toric implantable Collamer Lens (ICL) implantation. The patient's best corrected visual acuity was 0.7 in both eyes before the operation. After the treatment, his uncorrected visual acuity was 0.9 and corrected visual acuity was 1.0 in both eyes, indicating an improvement in visual function. Preoperative endothelial cell density measured 3,063 cells/mm2 in the right eye and 3,126 cells/mm2 in the left eye. At 5 years postoperatively, measurements were 2,897 cells/mm2 in the right eye and 2,974 cells/mm2 in the left, showing little change. However, a 6-year postoperative measurement of 2,198 cells/mm2 in the right eye and 2,803 cells/mm2 in the left showed a slight decrease in endothelial cell density in the right eye, and a follow-up measurement one year later displayed a rapid decline to 1,272 cells/mm2 in the right eye and 2,852 cells/mm2 in the left eye. The Toric ICL lens was removed from the right eye and phacoemulsification and posterior chamber intraocular lens implantation was performed. Two-month postoperative endothelial cell density was 1,257 cells/mm2 and endothelial cell damage from the operation itself was minimal.
CONCLUSIONS
ICL implantation may cause complications related to corneal endothelial cells as well as glaucoma. Patients should receive regular follow-up examinations for endothelial cell density.

Keyword

Endothelial cell loss; ICL implantation; Implantable contact lens

MeSH Terms

Astigmatism
Endothelial Cells*
Follow-Up Studies
Glaucoma
Humans
Lens Implantation, Intraocular
Lenses, Intraocular*
Middle Aged
Myopia
Phacoemulsification
Phakic Intraocular Lenses
Visual Acuity

Figure

  • Figure 1. Corneal endothelial cell density of the right eye. (A) Before ICL implantation operation. (B) Seven years after ICL implantation operation. R = right; T = thickness; N = number; SD = standard deviation; CV = coefficient of variation; CD = cell density; ICL = implantable contact lens.

  • Figure 2. Changes in corneal endothelial cell density. OD = oculus dexter (the right eye); OS = oculus sinister (the left eye).


Reference

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