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Study: Cell deposits on Artiflex phakic IOLs correlate with surgical experience
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STOCKHOLM, Sweden — The presence of cell deposits on Artiflex iris-claw phakic IOLs after implantation is a relatively frequent complication that is correlated with no factor other than the surgical learning curve, according to a study.
"The Artiflex (Ophtec) has extremely good refractive results, and it is almost complication-free," Antonio Marinho, MD, said here at the European Society of Cataract and Refractive Surgeons meeting. "Nevertheless, several surgeons report pigment cell deposits on the IOL or even giant cell deposits with mild uveitis."
Dr. Marinho and colleagues in Portugal investigated the frequency of cell deposits and intraocular inflammation after implantation of the phakic IOL. The study included 133 eyes of 75 patients treated by four surgeons and divided into four groups.
The first group included 95 eyes (71.5%) that showed no detectable inflammation. In the second group, cell deposits were detected on the IOL in 23 eyes (17.3%), but the deposits caused no visual disturbances and disappeared spontaneously between 3 and 6 months postop. The third group included eight eyes (6%) that were similar to those in the second group. However, the cell deposits in the third group of eyes were more persistent, remaining on the lens for longer than 6 months after implantation. The fourth group included seven eyes (5.2%) that experienced inflammation, pigment deposits and giant cell deposits that required treatment with steroids, according to the study.
"We correlated these different types of eye behaviors with several factors, [such as] age, sex, anterior chamber depth, pupil size, IOL power and surgeon experience," Dr. Marinho said.
No correlation was found between the different degrees of ocular inflammation and any of the patient variables. However, a strong correlation was found with surgical experience.
"The most experienced surgeon (99 eyes implanted) had 77% of the patients in the group with no detectable inflammation and only 4% in the group requiring treatment, while the least experienced surgeon (eight implanted eyes) had 25% of the eyes requiring treatment and none without detectable inflammation," Dr. Marinho said.
"The surgeon's learning curve is an important point which should not be disregarded when patients are selected to receive this phakic IOL," he said.