Efficacy comparison between rigid and foldable anterior iris-fixated phakic intraocular lens implantation for treating high myopia in Asian eyes

Abstract

AIM:To compare refractive and safety outcome of Artisan and Artiflex phakic intraocular lens(PIOL)for the correction of high myopia in Asian population.METHODS:Historical cohort study. A total of 81 high myopic eyes that underwent PIOL implantation from 2016 to 2020 at Yap Eye Hospital in Yogyakarta, Indonesia were reviewed. The patients were divided into two groups based on PIOL implanted, with 43 eyes using Artisan PIOL in Artisan group and 38 eyes using Artiflex PIOL in Artiflex group. Visual acuity, corneal biomicroscopy parameters, and intraocular pressure(IOP)were respectively recorded prior to the implantation and at 1d, 1 and 3mo after surgery. In addition, anterior chamber depth was documented before PIOL implantation.RESULTS:Mean follow-up period were 9.64±6.93mo and 8.96±4.28mo in Artisan an Artiflex group, respectively(P=0.736). The efficacy index was 1.03±0.47 in Artisan group, and 1.02±0.17 in the Artiflex group(P=0.119).The safety index was 1.10±0.45 and 1.05±0.21 in Artisan and Artiflex group, respectively(P<0.001). The mean spherical equivalent(SE)in Artisan group was -0.64±0.996D, and it was -0.22±0.58D in Artiflex group(P=0.076). In both groups, there was a significant loss of endothelial cell density(ECD)postoperatively compare to baseline(P<0.05), and the cumulative ECD loss was 7.44% and 5.79% in the Artisan and Artiflex groups, respectively(P=0.418).CONCLUSION:Artisan and Artiflex are comparable in terms of refractive outcome to correct high myopia in Asian eyes. Artisan had a slightly better safety index compare to Artiflex. However, the efficacy index and cumulative ECD loss was similar in both the Artisan and Artiflex groups.

Keywords

• phakic intraocular lens
• anterior iris-fixated
• artisan lens
• artiflex lens
• endothelial cells density
• high myopia