Artisan Phakic Intraocular Lens in Patients With Keratoconus

Abstract

The implantation of Artisan iris-fixated pIOLs in patients with stable keratoconus for correction of astigmatism and myopia is safe, predictable, and effective with minimal complications. Due to the progressive nature of keratoconus, proper patient counseling is necessary.

Collagen crosslinking and toric iris-claw phakic intraocular lens for myopic astigmatism in progressive mild to moderate keratoconus

“…The enclavation system prevents potential rotation of the IOL, which would result in loss of the refractive correction effect. 12,[16][17][18] In our study, 82% of the eyes were within G0.50 D of the attempted SE correction and 76% were within G1.00 D of attempted cylinder correction, which is comparable to the results of iris-claw pIOLs in nonkeratoconic eyes. 44,45 Alfonso et al 14 report similar SE results with posterior chamber Implantable Collamer Lens pIOLs, with 84% of eyes being within G0.50 D. Cylinder results were slightly better than in our series; that is, all eyes in the Alfonso et al study were within G1.00 D. However, all their patients had a refractive cylinder less than À3.00 D.…”

“…1,2 Visual rehabilitation of keratoconus has evolved rapidly in parallel with developments in the field of refractive surgery, such as intrastromal corneal ring segments (ICRS), [3][4][5][6][7][8][9][10][11] phakic intraocular lenses (pIOLs), [9][10][11][12][13][14][15][16][17][18] and toric pseudophakic IOLs if cataract is present. 19,20,A In mild to moderate keratoconus, these techniques are promising alternatives to the classic methods of spectacles, contact lenses, and corneal transplantation.…”

Phakic intraocular lenses

“…Several studies address clinical outcome after toric pIOL implantation. 27,30,36,37,39 Recently, G€ uell et al 27 reported a larger series with a mean follow-up of 3 years after implantation of the toric Artisan pIOL. The toric Artiflex is currently undergoing a multicenter clinical trial; it has shown excellent interim efficacy and safety results in the first 6 months of follow-up.…”

Toric collagen copolymer phakic intraocular lens to correct myopic astigmatism in eyes with pellucid marginal degeneration

“…[12][13][14][15][16] Given that the progression of corneal thinning and ectasia in PMD, like keratoconus, tends to stabilize in the third or fourth decade of life, 17 toric pIOL implantation may be another option for the surgical correction of myopic astigmatism in this setting. Studies [18][19][20] are beginning to show the safety and efficacy of this treatment modality in keratoconus. To our knowledge, there is only 1 case report of a patient with PMD who derived benefit from toric pIOL implantation.…”

“…Based on these studies, surgeons are now using toric pIOLs to successfully treat myopic astigmatism in keratoconus and keratoconus-suspect eyes. [18][19][20] In the largest case series of keratoconic eyes with the toric pIOL (25 eyes), 18 the mean postoperative SE refraction was 0.32 G 0.6 D at 1 year, with 84% of cases being within G0.50 D of emmetropia. The mean postoperative UDVA and CDVA were 0.17 G 0.6 (20/30) and 0.12 G 0.1 logMAR (20/25), respectively.…”