Correction of myopic astigmatism with a foldable iris-claw toric phakic intraocular lens: Short-term follow-up

Ruckhofer, Josef; Seyeddain, Orang; Dexl, Alois K.; Grabner, Günther; Stoiber, J.

doi:10.1016/j.jcrs.2011.11.027

Cited by 23 publications

(22 citation statements)

References 28 publications

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“…In our study, ECD significantly decreased in both groups, with comparable percent changes from baseline to 6 months. These results are in accordance with previous results regarding iris-fixated pIOLs 123…”

Section: Discussionsupporting

confidence: 93%

“…The toric pIOL can be inserted through a 3.2-mm incision, minimizing surgically induced and irregular astigmatism. In one study conducted by Ruckhofer, et al,1 the mean residual astigmatism was -0.18±0.30 D after toric pIOL implantation. Other studies have also shown relatively low residual cylindrical error with this method (multicenter study, 0.38±0.41 D2; two long-term follow-up studies, -0.39 D and -0.60 D34).…”

Section: Discussionmentioning

confidence: 93%

“…Despite the wide variety of phakic intraocular lenses (pIOLs) that yield good results, the correction of moderate-to-high astigmatism remains a challenge 1. The foldable iris-fixated pIOL (hereafter, non-toric pIOL; Artiflex, Ophtec BV, Groningen, the Netherlands) can be implanted through a small incision,2 minimizing surgically induced astigmatism, but only corrects spherical error.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism

Lee

Kang³

et al. 2016

Yonsei Med J

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PurposeTo compare the effectiveness of toric foldable iris-fixated phakic intraocular lens (pIOL) implantation and non-toric foldable iris-fixated pIOL implantation with limbal relaxing incisions (LRIs) for correcting moderate-to-high astigmatism in myopic eyes.Materials and MethodsThe medical records of 146 patients (195 eyes) with myopic astigmatism who underwent toric foldable iris-fixated pIOL implantation (toric group; 94 eyes) or non-toric foldable iris-fixated pIOL implantation with concurrent LRIs (LRI group; 101 eyes) were retrospectively reviewed. For subgroup analysis, the two groups were subdivided according to preoperative astigmatic severity [moderate, 2.00 to <3.00 diopters (D); high, 3.00–4.00 D]. Visual and astigmatic outcomes were compared 6 months postoperatively.ResultsThe uncorrected distance visual acuity was at least 20/25 in 100% and 98% of the toric and LRI group eyes, respectively. The toric group had lower mean residual cylindrical error (-0.67±0.39 D vs. -1.14±0.56 D; p<0.001) and greater mean cylindrical error change (2.17±0.56 D vs. 1.63±0.72 D; p<0.001) than the LRI group, regardless of the preoperative astigmatic severity. The mean correction index (1.10±0.16 vs. 0.72±0.24; p<0.001) and success index (0.24±0.14 vs. 0.42±0.21; p<0.001) also differed significantly between the groups.ConclusionBoth surgical techniques considerably reduced astigmatism and had comparable visual outcomes. However, toric foldable iris-fixated pIOL implantation was more reliable for correcting moderate-to-high astigmatism in myopic eyes.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism

Lee

Kang³

et al. 2016

Yonsei Med J

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“…The effectiveness and safety of the spherical and toric Artiflex IOL have been demonstrated in various clinical studies 2,6–8. A concern following an anterior-chamber p-IOL implantation is the ongoing impact of the implant over time on the surrounding structures of the anterior segment, eg, the iridocorneal angle, the endothelium, and the crystalline lens.…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have demonstrated that both the Artiflex and the Artisan offer predictable and stable postoperative refractive outcome 3–8. The long-term impact of anterior-chamber p-IOL implantation on corneal endothelial cell loss has been a matter of significant research and debate.…”

Section: Introductionmentioning

confidence: 99%

Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference

Ferreira¹,

Portelinha²

2014

OPTH

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PurposeTo evaluate the distance between the endothelial surface of the cornea to the anterior edge of an Artiflex® phakic intraocular lens (IOL) implant to improve the safety profile of this implant.MethodsThis is a retrospective clinical case series of 45 patients who had Artiflex phakic IOL implantation (Artiflex p-IOL) with a follow-up period of 3 years. A Pentacam HR imaging system was used to measure the distance from various points of the anterior edge of the Artiflex IOL to the endothelial surface of the cornea, which we called endothelial–IOL (E–IOL) distance, in 45 eyes. The E–IOL distances were assessed at 1, 3, 6, 12, 24, and 36 months. Corresponding correlations of central endothelial distance to temporal and nasal edges and center of the IOL anterior surface were tabulated.ResultsMean follow-up was 21.39±11.28 months. A statistically significant reduction of the E–IOL distance was observed over the follow-up period (P<0.05), with the mean annual reduction being 24.70 μm. A strong positive correlation between the E–IOL distance of the edges of the IOL and the central distance was observed (correlation coefficients nasal/central: month 1, 0.905; month 36, 0.806; temporal/central: month 1, 0.906; month 36, 0.806; P<0.001). Moderate negative correlations were found between the spherical equivalent power of the implanted IOL and the E–IOL distance (correlation coefficients −0.271 to −0.412, P>0.05). For an E–IOL distance of the IOL edge >1500 μm, the distance from the endothelium to the central point of the p-IOL optic should be a minimum of 1,700 μm to improve the safety profile for Artiflex p-IOL implantation and reduce the potential complication of accelerated endothelial cell loss.ConclusionAfter Artiflex IOL implantation, the mean annual reduction of the E–IOL distance was 25 μm. A negative correlation existed between the spherical equivalent power of the implanted IOL and the postoperative E–IOL distance. The minimum E–IOL distance from the center of the IOL to minimize the risk of endothelial cell loss was 1.7 mm. This distance, as is the 1.5 mm initially proposed by Baikoff, is a postoperative value. We cannot make that assumption for the preoperative evaluation, as the morphometry of the anterior chamber changes with the implant.

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Astigmatismus: Diagnose und Therapie

Ardjomand,

Wissiak

2023

Springer Reference Medizin

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Correction of myopic astigmatism with a foldable iris-claw toric phakic intraocular lens: Short-term follow-up

Abstract: After a short-time follow-up, toric pIOL implantation was effective, predictable, stable, and safe for the correction of myopic astigmatism.

Cited by 23 publications

References 28 publications

Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism

Comparison of Toric Foldable Iris-Fixated Phakic Intraocular Lens Implantation and Limbal Relaxing Incisions for Moderate-to-High Myopic Astigmatism

Endothelial distance after phakic iris-fixated intraocular lens implantation: a new safety reference

Astigmatismus: Diagnose und Therapie

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