PURPOSE: To determine the changes in endothelial cell density, refractive results, and risk factors associated with endothelial loss in patients with irisclaw phakic intraocular lenses for myopia/myopic astigmatism (Artisan). METHODOLOGY: Data collection was obtained from an existing database with information on patients with a phakic Artisan lens implant between 1998 and 2011 at the Virgilio Galvis Ophthalmology Centre, with at least 5 years of follow-up. As a second stage, an analysis was carried out to identify the change in endothelial cell density and its potential associated factors. RESULTS: A total of 80 eyes with myopic errors were included with a follow-up of 11.9 + 3.48 years. The percentage of total loss of endothelial cells was greater than 25% of the preoperative density in 43.8% of the eyes. A postoperative annual loss > 1.6% was found in 47.0% of the eyes with that information available. 41 eyes (51%) had final endothelial density < 2000 cells/mm2, and 7 (8.8%) eyes had endothelial cell density < 1000 cells/mm2. Among the variables studied, no associated factors for long-term endothelial loss were found. During the course of the study, 8 (10%) phakic intraocular lenses were explanted, including 3 with accelerated endothelial loss, and another 2 with cataract associated and a significantly low endothelial density. The last mean spherical equivalent was -0.81 (±1.01 D), and the final uncorrected distance visual acuity was 0.45 logMar (Snellen 20/56). CONCLUSION: Artisan-type phakic lenses are a good alternative for the correction of high myopic defects, with predictable refractive results in the long term. However, there is an increased loss of endothelial cells in the long term in a high percentage of patients. Strict postoperative follow-up, including endothelial evaluation, is required, and further studies are warranted.

• Klíčová slova
• Refractive surgery, corneal endothelium, corneal oedema, intraocular phakic lens, loss of endothelial cells, refractive surgery,
• MeSH
• astigmatismus * etiologie   MeSH
• endoteliální buňky MeSH
• fakické nitrooční čočky * škodlivé účinky   MeSH
• implantace nitrooční čočky škodlivé účinky   MeSH
• lidé MeSH
• myopie * chirurgie   MeSH
• následné studie MeSH
• nitrooční čočky * MeSH
• počet buněk MeSH
• refrakce oka MeSH
• rohovkový endotel MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Phakic intraocular lenses are used to correct refractive errors. The procedure is predictable and potentially reversible. The procedure is not free of complications though. The occurrence of iris cyst after implantation of a phakic intraocular lens was not described previously in the literature. We describe two cases of iris cysts in the presence of a phakic intraocular lens; the first case describes a cyst which was not present prior to the anterior chamber phakic intraocular lens implantation. The second case describes a hidden iris cyst that affected the posterior chamber phakic intraocular lens position and lead to glaucoma.

• Klíčová slova
• Phakic intraocular lens, complications, glaucoma, iris cyst,
• MeSH
• corpus ciliare patologie   MeSH
• cysty diagnóza   etiologie   MeSH
• dospělí MeSH
• fakické nitrooční čočky škodlivé účinky   MeSH
• implantace nitrooční čočky škodlivé účinky   MeSH
• lidé MeSH
• myopie chirurgie   MeSH
• nemoci duhovky diagnóza   etiologie   chirurgie   MeSH
• nemoci uvey diagnóza   etiologie   chirurgie   MeSH
• vyšetření štěrbinovou lampou MeSH
• zraková ostrost fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE: To evaluate long-term refractive outcomes of implantable collamer lens (ICL) implantation and late postoperative complications. METHODS: We assessed outcomes of patients who underwent ICL implantation (type ICM V4 for myopia, ICH V3 for hyperopia, TICM V4 for astigmatism) in our department between 1998 and 2013. It comprised 62 eyes (40 myopic and 22 hyperopic). The average follow-up period was 10.5 years. We evaluated: uncorrected and best-corrected visual acuity (UCVA and BCVA), spherical equivalent (SE), ICL vault, endothelial cell density and late postoperative complications. RESULTS: In myopes, the average UCVA was 1.0±0.37 and BCVA 1.18±0.38, in hyperopes 0.78±0.19 and 1.14±0.18, respectively. The average SE in myopes, whose target refraction was emmetropia, was -0.6±0.83 Dsf, in hyperopes +0.73±0.93. Central ICL vault was 206.16μm±105.94, (range 10-427) in myopes, 195.5μm±109.09, (range 20-404) in hyperopes. The most common late postoperative complication was cataract formation. Three myopic eyes (7.5%) developed symptomatic anterior subcapsular opacities with loss of at least two lines of BCVA. Cataract significantly affecting visual acuity occurred in 5 myopic eyes (12.5%) and 2 hyperopic eyes (9.09%). In these eyes, ICL removal and cataract surgery was performed. CONCLUSIONS: In our experience, ICL implantation in moderate and high ametropia was effective and relatively safe. The most common late complication was cataract formation. This complication can be managed effectively surgically with good refractive outcomes without loss of BCVA.

• Klíčová slova
• Chirurgie réfractive, ICL, Implant phaque intra-oculaire de chambre postérieure, Implantable collamer lens, Implantable collamer lens (ICL), Posterior chamber phakic intraocular lens, Refractive surgery,
• MeSH
• dospělí MeSH
• fakické nitrooční čočky * škodlivé účinky   MeSH
• hypermetropie diagnóza   chirurgie   MeSH
• implantace nitrooční čočky škodlivé účinky   metody   MeSH
• lidé MeSH
• mladý dospělý MeSH
• myopie diagnóza   chirurgie   MeSH
• následné studie MeSH
• pooperační komplikace etiologie   MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH