title: Comparison of surgically induced astigmatism following iris-claw PIOL insertion with scleral, limbal, or corneal incisions.
abstract: OBJECTIVE
  To compare surgically induced astigmatism (SIA) based on incision site and evaluate the clinical results and astigmatic stability of iris-claw phakic intraocular lens (Artisan lens; Ophtec BV, Groningen, Netherlands) implantation.
  
  
  METHODS
  Eighty-five eyes of 53 patients with myopia who underwent Artisan lens implantation with a 6.2-mm incision and follow-up of 6 months were retrospectively observed. SIA was assessed using keratometric astigmatism at 6 months postoperatively for the incision sites of the sclera, limbus, and cornea, and the efficacy, safety, predictability, and astigmatic stability were also calculated.
  
  
  RESULTS
  SIA obtained using Naeser's polar method (KP[90]SIA) was -0.48 ± 0.35 for scleral incisions, -0.99 ± 0.35 for limbal incisions, and -1.14 ± 0.54 for corneal incisions. Corresponding net astigmatism values, as calculated with KP(90)SIA and KP(135)SIA, were 0.70 ± 0.48 (177°), 1.04 ± 0.37 (175°), and 1.21 ± 0.57 (1°), respectively, with SIA increasing the nearer the incision was to the cornea center. Six months after surgery, the efficacy index was 1.03 and the safety index was 1.08. Ninety-eight percent of patients were within 1.50 diopters of attempted refraction.
  
  
  CONCLUSIONS
  The values of SIA after Artisan lens insertion showed significant differences among three incision locations, despite the absence of significant differences in preoperative steep corneal axis astigmatism values at the incision locations. It would be applicable for refractive surgery in the aspect of minimizing astigmatism after surgery.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Kwon
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Nam
authors.forename: R Doyle
authors.initials: RD
authors.lastname: Stulting
authors.forename: Chan Young
authors.initials: CY
authors.lastname: Lim
authors.forename: Kyoung Yul
authors.initials: KY
authors.lastname: Seo
mesh_terms: D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000209:etiology*; D003315:Cornea / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D007498:Iris / Q000601:surgery; D019654:Lens Implantation, Intraocular / Q000379:methods*; D016850:Limbus Corneae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D055815:Young Adult