Five-Year Follow-up of 399 Phakic Artisan–Verisyse Implantation for Myopia, Hyperopia, and/or Astigmatism
Presented in part at: American Academy of Ophthalmology Annual Meeting, October 2005, Chicago, Illinois.
Received 4 December 2006; received in revised form 6 August 2007; accepted 10 August 2007. published online 01 November 2007.
Purpose
To report long-term results of Artisan–Verisyse phakic intraocular lenses (PIOLs) to correct myopia, hyperopia, and/or astigmatism and the percentage of additional keratorefractive surgery to eliminate residual refractive errors.
Design
Retrospective, nonrandomized, interventional case series.
Participants
From January 1996 to January 2003, 399 Artisan–Verisyse PIOLs were consecutively implanted. To correct myopia, 101 5-mm optic Verisyse PIOLs (group 1) and 173 6-mm optic Verisyse PIOLs (group 2) were implanted. Forty-one were PIOLs for hyperopia (group 3), and 84 were toric (group 4).
Methods
Manifest refraction, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), biomicroscopy, tonometry, funduscopy, and central endothelial cell count (ECC) were determined before surgery, at 3 months, and at yearly intervals up to 5 years.
Main Outcome Measures
Refraction, UCVA, BSCVA, efficacy and safety indexes, enhancements' rate with keratorefractive surgery, central ECC, and complications.
Results
Mean follow-up was 4.05 years. Mean preoperative spherical equivalent (SE) and that at last follow-up were, respectively, −19.8±3.23 and −0.5 ± 0.89 diopters (D) (group 1), −11.27±3.11 and −0.64±0.8 D (group 2), +4.92±1.7 and +0.02±0.51 D (group 3), and −6.82±8.69 and −0.09±0.64 D (group 4). Group 4 had a mean preoperative cylinder of −3.24±1.02 D, which decreased to −0.83±0.74 D postoperatively. Additional keratorefractive surgery was performed in 60.39% of eyes (group 1), 19.6% (group 2), 41.4% (group 3), and 5.95% (group 4). Mean preoperative central ECC and that at last follow-up were, respectively, 2836±398 and 2514±529 cells/mm2 (group 1), 2755±362 and 2454±588 cells/mm2 (group 2), 2735±355 and 2560±335 cells/mm2 (group 3), and 2632±543 and 2537±615 cells/mm2 (group 4). Main complications were 3 explantations due to an unacceptable drop in ECC, 3 lenses' repositioning (2 ocular trauma and 1 unappropriate iris capture), 3 lenses' exchange due to refractive errors, 1 macular hemorrhage, 1 retinal detachment, and 2 cataracts.
Conclusions
According to our experience, implantation of iris-claw PIOLs is a reversible, effective, stable, safe procedure in the first 5 years of follow-up.
Available online: November 5, 2007.
1Instituto de Microcirugia Ocular, Barcelona, Spain.
2Autonoma University of Barcelona, Barcelona, Spain.
3Cornea and Refractive Surgery Unit, Instituto Microcirugia Ocular, Barcelona, Spain.
Correspondence and reprint requests to Jose Luis Güell, MD, Instituto de Microcirugia Ocular, c/Munner 10, 08022 Barcelona, Spain.
Manuscript no. 2006-1395.
No author has any financial or proprietary interest in any material or method mentioned.
ABSTRACT