Eight-year follow-up of Artiflex and Artiflex Toric phakic intraocular lens

Abstract

Purpose: To analyse long-term efficacy, safety, visual and refractive stability and physiological changes of Artiflex Myopia and Toric phakic intraocular lenses (pIOL) separately throughout an 8-year follow-up. Design: Retrospective cohort study. Methods: A total of 67 eyes of 37 patients underwent Artiflex Myopia (47 eyes) or Artiflex Toric (20 eyes) implantation for correcting myopia and/or astigmatism. Follow-up evaluations were performed 1, 3, 5 and 8 years after surgery. Preoperative and postoperative data included corrected (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, endothelial cell density (ECD) and intraocular pressure (IOP) assessments. Efficacy and safety indexes were analysed. The vectorial analysis was performed using the Thibos method. Results: Mean CDVA and UDVA of both pIOLs significantly improved from preoperative to 1 year after implantation, and then it remained stable over the 8-year follow-up. The efficacy and safety indexes after 8 years were 0.94 ± 0.16 and 1.07 ± 0.18 for Artiflex Myopia and 1.00 ± 0.11 and 1.10 ± 0.15 for Artiflex Toric, respectively. The spherical equivalent (SE) significantly improved after surgery. J0, J45 and SE refractive components showed no changes between postoperative visits. A total ECD loss of 4.8% ( p < 0.001) and 10.4% ( p = 0.005) was found after 8 years for Artiflex Myopia and Toric, respectively. Conclusions: Artiflex Myopia and Toric pIOLs are a safe, efficient and predictable option for the correction of myopia and/or astigmatism. The vectorial analysis showed excellent rotation stability for the toric version.

Long-term results in patients with iris-fixated foldable phakic intraocular lenses for myopia and astigmatism

“…Compared with long-term results reported by Monteiro et al, Royo et al, and Castro de Luna et al, this value was between 0.94 and 1.10 at 5 to 6 years and between 0.94 and 1.10 at 10 years of follow-up. [5][6][7] Compared with Artisan long-term results showed by Tahzib et al, the safety index was 0.83 and 0.80 at 6 years and 10 years of follow-up, hence worse than our findings. 3 IOP was relatively stable along 15 years of follow-up, that is, between 14 and 15 mm Hg, which means that iridectomy was an effective solution to prevent ocular hypertension even 15 years after.…”

“…Furthermore, Royo et al included only 18 eyes with 10 years of follow-up, which may not representative of these populations which have a great variability of ECD, in contrast to our 187 eyes included. 6 The long-term results of Artisan showed the total ECL of 16.6% and 21.5% in the myopic and toric groups, which is similar to our results with Artiflex Myopia and worse than our results with Artiflex Toric, without discounting a physiologic ECL per year, as in our study. 4…”

“…The chronic ECL showed a global annual decline of 34, 50, and 31 cell/mm 2 until the 5th, 10th, and 15th year of followup, respectively, which is similar to the 31.77 cell/mm 2 at 6 years found by Monteiro et al, but lower than 62 to 64 cell/ mm 2 at 5 years found by Jonker et al 2,5 The total ECL was 17.27% and 16.52% with Artiflex Myopia and Toric 10 years after surgery, more than the 13.97% found by Royo et al at 10 years of follow-up. 6 However, Royo et al achieved this result using the ECD at 1 month after surgery as the baseline and not the preoperative value. 6 This does not include surgery-related ECL, which may underestimate the overall endothelial cell loss with pIOL implantation.…”

“…6 However, Royo et al achieved this result using the ECD at 1 month after surgery as the baseline and not the preoperative value. 6 This does not include surgery-related ECL, which may underestimate the overall endothelial cell loss with pIOL implantation. Furthermore, Royo et al included only 18 eyes with 10 years of follow-up, which may not representative of these populations which have a great variability of ECD, in contrast to our 187 eyes included.…”

Comparison of Vision Correction and Corneal Thickness at 180-Day Follow-Up After Femtosecond Laser-Assisted In-Situ Keratomileusis (FS-LASIK), Photorefractive Keratectomy (PRK), and Small Incision Lenticule Extraction (SMILE): A Study from a Single Center in Poland of 120 Patients with Myopia

“…The effectiveness of the LVC method is defined as the ratio of postoperative uncorrected distance visual acuity (UDVA) to preoperative corrected distance visual acuity (CDVA) [ 24 ]. Patients should have a stable refraction within ±0.5 D for at least 1 year before undergoing SMILE [ 21 ].…”