Article Text

Download PDFPDF
Comparison of corneal endothelial cell density and morphology after posterior chamber phakic intraocular lens implantation with and without a central hole
  1. Hiroyasu Goukon,
  2. Kazutaka Kamiya,
  3. Kimiya Shimizu,
  4. Akihito Igarashi
  1. Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
  1. Correspondence to Dr Kazutaka Kamiya, Associate Professor, Department of Ophthalmology, University of Kitasato School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan; kamiyak-tky{at}


Aim To compare the corneal endothelial cells after posterior chamber phakic intraocular lens with and without a central hole (hole implantable collamer lens (ICL) and conventional ICL) implantation for the correction of moderate to high myopia.

Methods This retrospective study evaluated 34 eyes of 34 patients who underwent hole ICL implantation and 25 eyes of 25 patients who underwent conventional ICL implantation. Preoperatively and 3 months, and 1 and 2 years postoperatively, we compared the central corneal endothelial cell density (ECD), coefficient of variation in cell size (CV) and the percentage of hexagonal cells (HEX) between the two groups using a non-contact specular microscope (EM-3000, Tomey). Preoperatively and 2 years postoperatively, we also compared them in the peripheral regions.

Results The mean central ECD loss was 0.3% and 1.1%, 2 years after hole ICL and conventional ICL implantation, respectively (Mann-Whitney U test, p=0.72). There were no significant changes in central ECD, CV or HEX at any time points either after hole ICL or conventional ICL implantation, and a significant decrease only in terms of ECD in the superior regions after conventional ICL implantation.

Conclusions Both ICLs do not induce a significant change in the density, polymegethism or polymorphism of corneal endothelial cells even 2 years postoperatively, except for the density in the superior regions after conventional ICL implantation. However, hole ICL implantation may have advantages over conventional ICL implantation only in terms of the density in the superior regions, possibly because preoperative laser iridotomies are unnecessary.

  • Treatment Surgery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors The authors were involved in the acquisition, analysis or interpretation of data for the work (HG, KK, and AI); drafting the work or revising it critically for important intellectual content (HG and KK); final approval of the version to be published (HG, KK, KS, and AI); agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved (HG, KK, KS, and AI).

  • Competing interests Dr Shimizu is a consultant to STAAR Surgical. No other authors have commercial or propriety interest in the product or company described in the current article. This study was approved by the Institutional Review Board of Kitasato University and followed the tenets of the Declaration of Helsinki.

  • Patient consent Obtained.

  • Ethics approval Kitasato University.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost B Jonas