Evaluation of corneal endothelial cell loss and corneal thickness after cataract removal with light-adjustable intraocular lens implantation: 12-month follow-up

Abstract

Purpose: To determine quantitative changes in endothelial cell loss and corneal thickness in patients having cataract surgery and implantation of a light-adjustable intraocular lens (IOL) to correct residual postoperative refractive errors by application of a spatially profiled near-ultraviolet (UV) light.

Setting: Ruhr University Eye Clinic, Bochum, Germany.

Design: Cohort study.

Methods: The light-adjustable IOLs were implanted after phacoemulsification cataract surgery and treated with spatial-intensity-profiled UV light at 365 nm to induce a targeted refractive change. Once the desired correction was achieved, the light-adjustable IOL was treated again to lock-in the lens power. Noncontact computer-assisted endothelial cell microscopy and corneal pachymetry were performed before surgery; after surgery before adjustment; before lock-in; and 1, 3, 6, and 12 months after final lock-in.

Results: One hundred twenty-two eyes were evaluated 12 months after lock-in. The mean cumulative UV light dose at the cornea was 61.47 J/cm(2) ± 2.37 (SD). The mean endothelial cell loss was 6.91% ± 3.66% 2 weeks after surgery before adjustment and 6.57% ± 3.81% 12 months after lock-in. The mean relative change in corneal thickness from preoperatively was 6.18% ± 3.97% 2 weeks postoperatively and -0.64% ± 1.88% 12 months after lock-in.

Conclusions: Endothelial cell loss and corneal thickness change 12 months after lock-in agreed well with those reported in the literature after phacoemulsification with IOL implantation. The UV light exposure for adjustment and lock-in procedures did not add to the endothelial damage caused by the cataract surgery.