Purpose: To investigate changes in corneal endothelial cell density over 5 years after implantation of Artiflex lenses (Ophtec BV, Groningen, The Netherlands) and to explore the influence of anterior chamber depth and volume on changes in endothelial cell density. Methods: This study included 146 eyes of 88 patients implanted with foldable phakic iris-fixation intraocular (Artiflex) lenses for myopia correction from March 2009 to March 2014. To simulate chronological changes in endothelial cell density with age, we collected normal endothelial cell density data from 100 healthy subjects aged 20, 25, or 30 years, and compared the changes among these groups at 5 years after surgery. Changes in corneal endothelial cell density were compared among four groups to which subjects were assigned based on the distance from the intraocular lens to the corneal endothelium, and the volume and depth of the preoperative anterior chamber. Results: The mean endothelial cell density, pre-operatively and at 1, 3, and 5 years post-operatively, was 3,038.8 ± 223.2, 2,985.3 ± 235.5, 2,905.1 ± 231.3, and 2,814.9 ± 250.5 cells/mm2, respectively (1.73%, 4.36%, and 7.31% reduction, respectively, vs. pre-operatively, p < 0.001). These differences were greater than those observed among different age groups (2.2% difference between 20- and 25-year-olds, and 1.2% difference between 25- and 30-year-olds, p < 0.001). A shorter distance from the lens to the endothelium and smaller anterior chamber volume were associated with greater decreases in endothelial cell density following surgery. Conclusions Corneal endothelial cell density significantly decreased during a 5-year follow-up after Artiflex lens implantation. The distance from the intraocular lens to the corneal endothelium, and the anterior chamber volume, were negatively correlated with the rate at which endothelial cell density decreased over time.

Purpose: To investigate changes in corneal endothelial cell density over 5 years after implantation of Artiflex lenses (Ophtec BV, Groningen, The Netherlands) and to explore the influence of anterior chamber depth and volume on changes in endothelial cell density. Methods: This study included 146 eyes of 88 patients implanted with foldable phakic iris-fixation intraocular (Artiflex) lenses for myopia correction from March 2009 to March 2014. To simulate chronological changes in endothelial cell density with age, we collected normal endothelial cell density data from 100 healthy subjects aged 20, 25, or 30 years, and compared the changes among these groups at 5 years after surgery. Changes in corneal endothelial cell density were compared among four groups to which subjects were assigned based on the distance from the intraocular lens to the corneal endothelium, and the volume and depth of the preoperative anterior chamber. Results: The mean endothelial cell density, pre-operatively and at 1, 3, and 5 years post-operatively, was 3,038.8 ± 223.2, 2,985.3 ± 235.5, 2,905.1 ± 231.3, and 2,814.9 ± 250.5 cells/mm2, respectively (1.73%, 4.36%, and 7.31% reduction, respectively, vs. pre-operatively, p < 0.001). These differences were greater than those observed among different age groups (2.2% difference between 20- and 25-year-olds, and 1.2% difference between 25- and 30-year-olds, p < 0.001). A shorter distance from the lens to the endothelium and smaller anterior chamber volume were associated with greater decreases in endothelial cell density following surgery. Conclusions Corneal endothelial cell density significantly decreased during a 5-year follow-up after Artiflex lens implantation. The distance from the intraocular lens to the corneal endothelium, and the anterior chamber volume, were negatively correlated with the rate at which endothelial cell density decreased over time.

Purpose: This study investigates the intraocular pressures and dry eye signs before and after botulinum toxin (botox) injections for patients with essential blepharospasm. Methods: From November 2021 to July 2022, a prospective study examined 78 eyes of 39 patients diagnosed with essential blepharospasm. Before injection and 1 and 3 months after injection, intraocular pressures (IOPs) were measured using a Goldmann applanation tonometer. The noninvasive breakup time (NIBUT), lipid layer thickness (LLT), tear meniscus height (TMH), and meibomian gland clearance were assessed with the aid of the IDRA platform (SBM Sistemi, Turin, Italy). Results: The average IOPs were 14.33 ± 3.47 (7-21), 13.45 ± 3.54 (9-21), and 13.28 ± 2.98 (7-20) mmHg before, and 1 and 3 months after, botox injection respectively (p = 0.002 , p = 0.004). Twenty-four eyes of 12 patients with dry eye symptoms evidenced a significant difference in the NIBUT 1 month after Botox injection, but no significant difference in any of the LLT, TMH, or meibomian gland areal loss percentage (p = 0.007, 0.201, 0.586, and 0.435 respectively). After 3 months, no dry eye parameter change, including the NIBUT, was significant (p = 0.202, 0.542, 0.240, and 0.721 respectively). Conclusions Botulinum toxin A injection temporarily relieved dry eye symptoms and reduced the IOP in patients with essential blepharospasm.