title: Comparison of three phakic intraocular lenses for correction of myopia.
abstract: OBJECTIVE
  To compare the visual outcomes and complications of three different types of phakic intraocular lenses (PIOLs), for correction of moderate to high myopia.
  
  
  METHODS
  We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer lens (ICL, 36 eyes). Best corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared.
  
  
  RESULTS
  Mean follow-up period was 30 ± 11 months. Preoperatively, spherical equivalent (SE) refractive error was -11.6 ± 3.7, -9.59 ± 1.97, and -12.3 ± 4.8 D in the Artisan, Artiflex and ICL groups, respectively. SE was comparable among the study groups at final follow-up (P = 0.237). Mean astigmatic reduction was 0.31 ± 0.72, 0.45 ± 0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P = 0.007). Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P = 0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P = 0.158); pachymetric changes were minimal with no difference among the three groups (P = 0.754), and mean CEC loss was 10 ± 9%, 9 ± 6% and 9 ± 10% in the Artisan, Artiflex and ICL groups, respectively (P = 0.694). HOAs (P = 0.039), vertical trefoil (P = 0.032) and spherical aberration (P = 0.001) were higher with Artisan group as compared to ICL. Total aberrations (P = 0.028) and spherical aberration (P = 0.001) was also higher with Artisan group as compared to Artiflex.
  
  
  CONCLUSIONS
  Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Karimian
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Baradaran-Rafii
authors.affiliation: Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Javad
authors.initials: SJ
authors.lastname: Hashemian
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Hashemloo
authors.affiliation: Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ebrahim
authors.initials: ME
authors.lastname: Jafari
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Yaseri
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Ghahari
authors.affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Shadi
authors.initials: S
authors.lastname: Akbarian
keywords: Artiflex; Artisan; Implantable Collamer Lens; Phakic Intraocular Lens