Refractive lens exchange versus iris-claw Artisan phakic intraocular lens for hyperopia

Area of Science:

• Ophthalmology
• Refractive Surgery
• Intraocular Lenses

Background:

• High hyperopia presents significant visual challenges.
• Intraocular lens (IOL) implantation is a surgical option for correcting high hyperopia.
• Comparing different IOL types is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the outcomes of Artisan phakic IOL implantation versus refractive lens exchange (RLE) with pseudophakic IOLs in patients with high hyperopia.

Main Methods:

• A paired-match comparison was conducted between 19 eyes with Artisan phakic IOLs and 19 eyes that underwent RLE.
• Patients ranged from 20 to 46 years old with hyperopia between +2.75 D and +9.25 D.
• Outcomes were assessed based on refractive error, visual acuity, and accuracy of achieved refraction.

Main Results:

• Both procedures resulted in similar spherical equivalent refraction and best spectacle-corrected visual acuity (BSCVA) at 1 month post-surgery.
• Artisan phakic IOLs demonstrated statistically better accuracy in achieving intended refraction (R=0.83) compared to RLE (R=0.50).
• Uncorrected visual acuity (UCVA) improved in both groups, with phakic IOLs showing a slight initial advantage.

Conclusions:

• Refractive lens exchange and Artisan phakic IOL implantation yield comparable visual acuity outcomes.
• Artisan phakic IOLs provide superior refractive predictability for young, high hyperopia patients with preserved accommodation.
• Careful patient selection is key for optimizing outcomes with phakic IOLs.