Comparison of rigid versus foldable iris-fixed phakic intraocular lens implantation for high myopia

Abstract

Background: This study aimed to assess the efficacy of rigid versus foldable iris-fixed phakic intraocular lens (PIOL) implantation in the treatment of high myopia. Methods: A systematic search based on electronic databases such as Pubmed, Embase, and Cochrane Library was conducted to identify relevant studies published up to January 11, 2019. The pooled odds ratios and weighted mean differences (WMDs) with corresponding 95% confidence intervals were calculated. Results: Eight comparative studies with 835 participants were included in this meta-analysis. The overall WMD showed statistical significance in terms of postoperative uncorrected distance visual acuity (UDVA), mean postoperative spherical equivalence (SE), and mean postoperative intraocular higher-order aberrations (HOA) (μm) for a 6-mm pupil, suggesting that foldable PIOL group showed significant improvement of high myopia, compared to rigid PIOL group. Besides, compared with rigid PIOL group, foldable PIOL group had beneficial effect on the proportion of eyes with central endothelial cell density (ECD) loss in patients with high myopia. Conclusion: This meta-analysis provided the up-to-date evidence and found that foldable PIOL group had significant beneficial effect on UDVA, SE, HOA, contrast sensitivity, and ECD, except best spectacle-corrected visual acuity, and safety in the treatment of high myopia over rigid PIOL group.

Long term efficacy and safety profiles of iris-fixated foldable anterior chamber phakic intraocular lens implantation in eyes with ≥ 10-year follow-up

“…Meta-analyses compared the outcomes of both, Artisan and Artiflex IOLs, showing that the latter had a beneficial effect on UDVA, CDVA, SE, efficacy, predictability, higherorder aberrations, and contrast sensitivity in the treatment of high myopia. 1,2 However, long-term results regarding Artiflex pIOL clinical and refractive outcomes, including efficacy, safety, predictability, and stability, are scarce. 11 In this study, we found that over the entire follow-up, Artiflex pIOL was associated with good efficacy and safety.…”

“…It preserves crystalline accommodation, is reversible, does not alter the corneal tissue, and avoids the risk for retinal detachment after refractive lens exchange. 1,2 The first AC iris-claw lens prototype was initially developed by Fechner and Worst in 1978 and modified to a convex-concave configuration in 1991. Since then, modifications in optic diameter were made to reduce optic phenomena and glare, improving the safety of the procedure.…”

“…It preserves crystalline accommodation, is reversible, does not alter the corneal tissue, and avoids the risk for retinal detachment after refractive lens exchange. 1,2…”

Comparison of Iris Claw Phakic Lenses Implant Versus Corneal Laser Techniques in High Myopia. Five Years Follow-up

“…According to the Miraftab et al [39] 3-year results, phakic lens implantation is better than PRK-MMC for treating patients with myopia > 8.0D. A systematic review by Wu et al [40] compared both types of iris-anchored phakic lenses, rigid and foldable, provided updated evidence. They found that the foldable lens group was superior in e cacy and safety in treating high myopia to the rigid lens group.…”

Comparison of Iris-Claw Phakic Lens Implant versus Corneal Laser Techniques in High Myopia: A Five-Year Follow-Up Study

“…However, the two methods had no difference in visual acuity. According to the Miraftab et al’s [ 38 ] 3-year results, phakic lens implantation is better than PRK-MMC for treating patients with myopia > 8.0 D. A systematic review by Wu et al [ 39 ] compared both types of iris-anchored phakic lenses, rigid and foldable, provided updated evidence. They found that the foldable lens group was superior in efficacy and safety in treating high myopia to the rigid lens group.…”