Exposing the LASIK Scam

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 Post subject: Phakic IOLs/ICLs
PostPosted: Fri Jul 27, 2007 1:58 am 

Joined: Sat Nov 26, 2005 1:23 pm
Posts: 2080
Outcomes of ZB5M Angle-supported Anterior Chamber Phakic Intraocular Lenses at 12 Years

Journal of Refractive Surgery Vol. 23 No. 2 February 2007

Jaime Javaloy, MD, PhD; Jorge L. Ali?, MD, PhD; Maria T. Iradier, MD; Ayman M. Abdelrahman, MD, MSc; Tomas Javaloy, MD; Fernando Borr?s, MD, PhD

For the IOL models analyzed in this study, a constant greater loss of endothelial cell density has been found. Considering a physiological rate of decrease in the endothelial cell density of 0.56% per year, a nonoperated healthy eye would reach age 85 years with >1900 cells/mm2. For these calculations, an amortization equation for accounting
has to be used:


where ECDi is the current cell density estimated at any moment, ECD0 is the cell density at the fi rst considered instant, and n the number of years for calculating ECDi.

As we estimate a 10.69% surgically induced decrease in the endothelial cell density in the first year and an average rate of 1.78% every year after that, a hypothetical 25-year-old patient with an endothelial cell density of 2500 cells/mm2 who received a ZB5M angle-supported PIOL would reach the advisable explantation number of 1500 cells/mm2 at age 49 years (24 years after implantation). Later enhancements in the design of these angle-supported PIOLs may reduce long-term endothelial damage. The absence of a definitive physiopathological model of endothelial injury after angle-supported PIOL implantation and the large number of eyes implanted, especially in young patients, should oblige surgeons to perform periodic endothelial cell analysis in these patients.

Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato

 Post subject:
PostPosted: Fri Oct 26, 2007 4:28 pm 

Joined: Thu Nov 24, 2005 9:06 pm
Posts: 297
J Cataract Refract Surg. 2007 Aug;33(8):1477-81.
Comment in:
J Cataract Refract Surg. 2007 Aug;33(8):1347.

Severe endothelial cell loss following uneventful angle-supported phakic intraocular lens implantation for high myopia.

Coullet J, Mahieu L, Malecaze F, Fourni? P, Leparmentier A, Moalic S, Arn? JL.
Department of Ophthalmology, Purpan Hospital, Toulouse, France. coullet.j@chu-toulouse.fr

Endothelial decompensation is a serious complication of phakic intraocular lens (pIOL) implantation and is a major concern during the postoperative period. We report 3 eyes in which the same foldable angle-supported pIOL was implanted to correct high myopia. Rapid and severe postoperative endothelial cell loss occurred in all 3 eyes. An over-sized pIOL that induced excessive vaulting into the anterior chamber was the main risk factor. In 2 eyes, the pIOL was explanted uneventfully; 1 eye required Descemet's stripping automated endothelial keratoplasty because of total endothelial decompensation. These cases illustrate the importance of accurate sizing of foldable angle-supported anterior chamber pIOLs to avoid excessive vaulting. They also highlight the importance of regular follow-up and preventive pIOL explantation as soon as significant endothelial cell loss is detected.


"What concerns me is that if the person informing the patient is themselves poorly or inaccurately informed then how on earth can consent ever be truly informed?" Dr. Sarah Smith

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