Artisan phakic intraocular lens in patients with keratoconus.
OBJECTIVE
To assess the safety, efficacy, predictability, and refractive outcome of implanting Ophtec Artisan phakic intraocular lenses (pIOLs) in eyes with keratoconus.


METHODS
In this retrospective study, 18 eyes of 11 patients diagnosed with keratoconus who underwent toric or myopic pIOL implantation were followed for 1 year postoperatively. Mean patient age was 41+/-10.97 years (range: 23 to 64 years). Preoperative manifest refractive sphere was -4.64+/-2.74 diopters (D) (range: -9.75 to 0.00 D) and cylinder was -3.07+/-2.04 D (range: -7.75 to -0.50 D). Inclusion criteria were preoperative best spectacle-corrected visual acuity (BSCVA) of 0.30 or better and stable refraction (</=0.50-D change in manifest refraction spherical equivalent [MRSE] yearly). Refractive outcomes and endothelial cell counts were analyzed primarily for 6-month follow-up and when available for 1-year follow-up.


RESULTS
The mean postoperative MRSE was -0.46+/-0.60 D (range: -1.88 to 0.13 D). Twenty-two percent (4/18) of eyes had an uncorrected visual acuity (UCVA) of 1.0 or better and 94% (17/18) of eyes had a UCVA of 0.63 or better. Sixty-one percent (11/18) of eyes had an MRSE within +/-0.50 D of the intended correction and 72% (13/18) of eyes gained one or more lines of BSCVA and no eyes lost lines of BSCVA. Mean endothelial cell counts decreased by 23 cells/mm(2) at 6 months postoperatively.


CONCLUSIONS
The implantation of Artisan iris-fixated pIOLs in patients with stable keratoconus for correction of astigmatism and myopia is safe, predictable, and effective with minimal complications. Due to the progressive nature of keratoconus, proper patient counseling is necessary.
Venter
Jan
J
Optical Express, London, United Kingdom. drjanventer@googlemail.com
D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D054120:Phakic Intraocular Lenses; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult