The Effect Of Implantation Of Iris-fixated Intraocular Lens For The Correction Of Aphakia

Objective To evaluate the efficacy, predictability, stability, safety and complications of secondary Artisan iris-fixated intraocular lens (Ophtec BV, Groningen, the Netherlands) implantation for the correction of aphakia without sufficient capsular support.Methods In this retrospective clinical study,62eyes of62patients underwent the implantation of the Artisan aphakic iris-fixated intraocular lens (IOLs) for aphakia correction. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refraction, endothelial cell density (ECD), intraocular pressure (IOP) and clinical complications were evaluated before and after the implantation. The follow-up was4years. Postoperative examinations were performed at1week,1month,6months,1year,2years,3years and4years after the implantation.Results After implantation, UCVA improved in all eyes (P<0.05). UCVA of20/40or better was observed in45eyes (72.6%), and BCVA of20/40or better was observed in50eyes (80.6%). Postoperative UCVA was equal to or better than preoperative BCVA in60eyes (96.8%). Two eyes had postoperative BCVA worse than preoperative BCVA. One eye had ischemic optic neuropathy and the other one had retinal detachment after the surgery. Mean spherical equivalent (SE) decreased significantly from11.69±1.17D to-0.55±0.45D (P<0.05), and SE was within±1.00D of the desired refraction in56eyes (90.3%) at the last follow-up. The mean endothelial cell lost3.97%,1.78%,1.73%,0.98%,0.94%,0.85%,0.57%at lweek, 1month,6months, lyear,2years,3years, and4years after the surgery, respectively. There was no significant postoperative IOP increase throughout the follow-up.8patients (12.9%) complained glare and halos during night driving which might be associated with their large pupils under scotopic conditions or IOLs decentration. Various density of pigment precipitates on the IOLs were observed in all eyes1day after surgery, but most were transient and absorbed after the application of topical corticosteroid. At the last follow-up, the pigment precipitates were reported in6eyes (9.68%), but they did not result in compromised visual acuity. No other serious intraoperative and postoperative complications occurred in this study.Conclusion After four-year follow-up, secondary implantation of Artisan aphakia IOLs is proved to be an effective, predictable, and safe procedure for the correction of aphakia without capsular support. However, longer follow-up with a larger cohort is necessary to confirm these conclusions.