Changes of the corneal endothelial cell count after Artisan phakic intraocular lens implantation

Introduction
Corneal refractive procedures are widely used by refractive surgeons for the treatment of myopia and other errors of refraction. However, these procedures are restricted by corneal thickness, corneal curvature, and the risk of postoperative ectasia. When dealing with high degrees of myopia, phakic intraocular lenses (pIOLs) can correct a wider range with a more superior quality of vision and refractive outcomes. However, the potential risk of damage to corneal endothelial cells remains one of the main concerns regarding pIOL implantation.
Aim
To evaluate the possibility and magnitude of endothelial cell loss following implantation of Artisan pIOL for the treatment of high myopia.
Patients and methods
The study comprised twelve eyes with high myopia implanted with Artisan pIOL. In this prospective interventional study, preoperative and postoperative specular microscopy (NIDEK CEM-530 Specular Microscope) was conducted to assess changes in endothelial cell count over 6 months.
Results
Preoperative mean endothelial cell count was 2748.33 ± 73.594 cells/mm. It was 2736.75 ± 82.275 cells/mm at 1 month after surgery, which changed to 2567.50 ± 104.458 cells/mm at 6 months postoperatively. The mean cell loss after 6 months was 6.19%. No significant changes were found in other endothelial parameters, including average cell size, percentage of hexagonality, and coefficient of variation. The mean uncorrected visual acuity improved from 0.033 ± 0.005 preoperatively to 0.708 ± 0.08 after surgery, and the mean spherical equivalent improved from −16.729 ± 1.303 D preoperatively to − 0.354 ± 0.161 D after surgery.
Conclusion
Implantation of Artisan lens is a safe way for dealing with high myopia. No significant change was observed in endothelial cells over 6 months of observation. It also had excellent results regarding its predictability and efficacy. A longer follow-up period is required to monitor the effect on the corneal endothelium on the long term.