A foldable anterior chamber phakic intraocular lens (IOL) can maintain effectiveness, predictability, stability, and safety for up to 10 years in patients with high myopia or astigmatism, according to a retrospective study published in the Journal of Cataract and Refractive Surgery.

The review looked at 10 years of data for 76 eyes of 40 patients who received the Artiflex (Ophtec B.V.) or Artisan (Ophtec B.V.) implants between 2008 and 2011. Investigators reviewed the participants’ safety, efficacy, predictability, and stability outcomes.

At baseline, the patient population was 44.7% men, aged mean 30.9±7.9 years, 48.7% had an affected right eye, preoperative uncorrected distance visual acuity (UDVA) was 0.05±0.02, corrected distance visual acuity (CDVA) was 0.88±0.15, spherical equivalent was -8.26±2.47 D, cylinder was -0.95±0.86 D, and endothelial cell count (ECC) was 2935±359 cells/mm2.


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During surgery, 85.5% of eyes received a spheric lens and 14.5% a toric lens.

At a follow-up of 10.67±0.64 years, 76% of eyes achieved UDVA of at least 20/40, 42% at least20/20, and 3% or at least 20/16. For CDVA, 39% gained at least 1 line, 57% were stable, and 4% lost a line. No eyes lost 2 or more lines.

The attempted correction was within ±0.50 D for 61% of eyes and within ±1.00 D for 76%. A refractive astigmatism of <5° was observed among 42% and <15° among 61%. In general, no overcorrections or undercorrections in magnitude were observed. The standard error at month 1 was -0.15±0.35 D and at final follow-up was -0.71±0.88 D, indicating total myopic progression (P <.01).

At 1-year, mean EEC was significantly reduced by 2.96% (P =.02) and at the final follow-up, was 2620±453 cells/mm2, indicating a chronic total cell loss of 0.98% per year (P <.01). This rate of EEC loss was 0.37% more than what is expected among eyes with no surgery.

IOP did not significantly change from baseline (mean, 14.26 vs 15.8; P =.24).

No intra or postoperative complications were reported. At 10.3 years, a patient aged 58 years developed nuclear cataracts, suggesting age-related onset. One patient not included in this analysis developed traumatic dislocation and required re-enclavation at 8.7 years.

Reference
Papa-Vettorazzi MR, Moura-Coelho N, Manero F, Cruz-Rodriguez JB, Elies D, Güell JL. Long term efficacy and safety profiles of iris-fixated foldable anterior chamber phakic intraocular lens implantation in eyes with ≥ 10-year follow-up. J Cataract Refract Surg. Published online March 18, 2022. doi:10.1097/j.jcrs.0000000000000937