title: Postoperative astigmatism and rotational stability after artisan toric phakic intraocular lens implantation.
abstract: OBJECTIVE
  To evaluate deviations in the axis (intended versus achieved) and postoperative astigmatism after implantation of an Artisan toric phakic intraocular lens (IOL).
  
  
  METHODS
  University Eye Hospital, Mainz, Germany.
  
  
  METHODS
  This prospective study comprised 29 eyes with high ametropia and astigmatism. All eyes had uneventful implantation of a toric phakic IOL through a superior scleral tunnel incision at 12 o'clock. After a minimum of 6 months, the uncorrected visual acuity (UCVA), best correct visual acuity, refraction, and astigmatism were analyzed in all eyes. A multivariate analysis of postoperative astigmatism was performed.
  
  
  RESULTS
  After a follow-up of at least 6 months, 95% of eyes were within +/-1.00 diopter (D) of emmetropia and 85% of eyes has a UCVA of 20/30 or better. The difference between the mean intended cylinder axis and achieved cylinder axis was 3.9 degrees (median 3 degrees; range to 13 degrees). The difference between the mean intended axis and the achieved axis between miosis and mydriasis was 1.8 degrees (median 1.5 degrees; range 0 to 5 degrees). The mean postoperative astigmatism after 6 months was 0.56 D with an axis of 31 degrees. Doubled-angle scatterplot analysis showed a tendency toward more flattening in the vertical meridian.
  
  
  CONCLUSIONS
  During the 6-month follow-up, no significant rotation was observed after implantation of Artisan toric phakic IOLs to correct high ametropia. A sutureless sclerocorneal superior approach for phakic IOL insertion resulted in moderate to low astigmatism. Induced astigmatism should be taken into consideration during preoperative planning.
authors.affiliation: Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. tehrani@augen.klinik.uni-mainz.de
authors.forename: Mana
authors.initials: M
authors.lastname: Tehrani
authors.forename: H Burkhard
authors.initials: HB
authors.lastname: Dick
authors.forename: Oliver
authors.initials: O
authors.lastname: Schwenn
authors.forename: Eric
authors.initials: E
authors.lastname: Blom
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Schmidt
authors.forename: Hans-Reinhard
authors.initials: HR
authors.lastname: Koch
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000379:methods; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012030:Refractive Errors / Q000150:complications; D054140:Refractive Surgical Procedures; D012399:Rotation