Severe inflammation following iris fixated anterior chamber phakic intraocular lens for myopia

Implantation of an iris-fixated phakic intraocular lens for the correction of hyperopia: 15-year follow-up

PURPOSE

To assess the predictability, efficacy, stability, and safety of implantation of an Artisan iris-fixated phakic intraocular lens (IF-pIOL) for the correction of hyperopia with a follow-up of up to 15 years.

SETTING

Leiden University Medical Center, the Netherlands.

METHODS

Patients operated by a single surgeon up to 2007 were identified, and data on refraction, corrected distance visual acuity (CDVA), uncorrected distance visual acuity, endothelial cell (EC) density, and complications were collected.

RESULTS

A total of 61 eyes (32 patients) were analysed. The mean spherical equivalent decreased from +6.43 ± 1.78 diopters (D) preimplantation to -0.22 ± 0.57 D at 1 year postimplantation and remained stable throughout follow-up. A stable CDVA with safety indices ranging from 0.91 to 1.10 and efficacy indices between 0.43 and 0.86 were observed. Follow-up time had a significant effect on EC density with an estimated annual decline of 58 cells/mm2 after IF-pIOL implantation. IF-pIOL explantation was performed in a 10 eyes (16.4%) after 8.13 ± 5.11 years. The main reason for IF-pIOL explantation was EC loss (4 eyes [6.6%]). Pigment dispersion was the most encountered complication, observed in 9 eyes (14.8%).

CONCLUSIONS

Visual and refractive results after implantation of an IF-pIOL to correct hyperopia show favorable and stable results with long-term follow-up. Lifelong monitoring of EC counts is mandatory. Pigment dispersion might be a problem in hyperopic eyes implanted with an IF-pIOL; a shallower anterior chamber depth and a convex iris configuration might be predisposing factors.

Visual outcomes following Artisan aphakia iris claw lens implantation

OBJECTIVE

To assess the visual outcome of eyes undergoing Artisan lens implantation for aphakia, to identify reasons for poor outcomes, and to report incidences of post-operative uveitis, glaucoma, or hyphaema.

METHODS

A retrospective analysis of 32 eyes rendered aphakic through various causes, which subsequently underwent Artisan lens implantation.

RESULTS

A total of 32 eyes from 31 patients were reviewed. Follow-up ranged from 6 to 42 months, mean 17.3 months. The commonest cause of aphakia was following complicated phacoemulsification in 17 of the 32 eyes (53.1%). At final follow-up, 21 of the 32 eyes (65.6%) achieved best-corrected visual acuity (BCVA) better than that measured pre-operatively and 10 of the 32 eyes (31.3%) matched their pre-operative BCVA. Of 33 eyes, only 1 (0.03%) attained a final BCVA worse than pre-operatively, owing to non-arteritic anterior ischaemic optic neuropathy. A total of 4 of the 33 eyes (12.5%) had pre-existing glaucoma or ocular hypertension; no additional intraocular pressure problems were identified during the follow-up period.

CONCLUSION

This study suggests that Artisan iris claw lens insertion is beneficial in acquired aphakia, matching or exceeding pre-operative BCVA in the overwhelming majority of the cases. In addition, this series did not identify any post-operative problems with uveitis, glaucoma, or hyphaema.