Wavefront aberration and contrast sensitivity after implantation of foldable and rigid iris claw phakic intraocular lenses: Artiflex versus artisan

Abstract

Aim of study:The aim of this study is to assess wavefront aberration and contrast sensitivity (CS) after implantation of foldable iris claw – artiflex- and rigid iris claw – artisan- phakic intraocular lenses (pIOLs).Materials and Methods:A nonrandomized prospective comparative case study was performed on 57 eyes; of which, 54 were myopia and 3 were hyperopia. Twenty-four patients had artisan pIOL implantation and 33 had artiflex pIOL implantation. Higher-order aberration (HOA) and CS were obtained 1 year after surgery.Results:Total HOA in artisan group was greater than artiflex group (P = 0.044) with a mean HOA of 0.44 ± 0.15 root mean square (RMS) for artisan and 0.35 ± 0.15 RMS for artiflex. Although, there were no significant differences in the vertical trefoil, vertical coma, horizontal trefoil, horizontal coma, secondary astigmatism, quatrefoil, and fourth order spherical aberration in two groups. CS in mesopic conditions was better in artiflex-treated eyes at three spatial frequencies of 6, 12, and 18 cycles per degree (cpd) (P = 0.003, P = 0.007, and P = 0.00, respectively), and no significant difference was seen between two lenses at 3 cpd.Conclusion:Although the components of HOA were not significantly different between two groups, total HOA was higher in artisan group, which may be due to the slight differences in each component, increasing the HOA as a total. CS was significantly better in artiflex group.

Artisan versus Artiflex phakic intraocular lens implantation in the treatment of moderate to high myopia: meta-analysis

“…Furthermore, evaluation of contrast sensitivity in mesopic condition presented no evident difference between two groups at spatial frequency of 3 cpd, but was significantly higher in Artiflex PIOL group at spatial frequencies of 6, 12 and 18 cpd. This result was similar with former studies [ 4 , 19 ]. Therefore, Artiflex PIOL was determined to bring about the better visual quality in myopia correction.…”

“…Four studies [ 4 , 9 , 11 , 15 ] measured mean postoperative BCVA. The difference of BCVA between two groups was statistically significant (Pooled WMD: 0.072; 95% CI: 0.005 to 0.139; P = 0.035) (Additional file 1 : Appendix I).…”

“…Artisan and Artiflex PIOL were widely used in the market among various designed lens. To our knowledge, a number of clinical comparative studies reported on outcomes after Artisan and Artiflex phakic intraocular lens have published [ 4 , 5 , 7 – 15 ]. It’s necessary to conduct integrative analysis to the postoperative effects of two surgical methods.…”

“…The phakic intraocular lens (pIOL) implantation has been proved to be a safer technique for correcting myopia ranging from − 6.00D to − 20.00D compared to excimer laser techniques, showing significant advantages on the maintaining of best corrected visual acuity (BCVA), contrast sensitivity (CS), biomechanical stability and visual effects [ 1 – 3 ]. Of various PIOLs having been designed, Artisan and Artiflex lenses, considered to provide good safety and efficacy, had been widely used since they were introduced into the market [ 4 , 5 ].…”

“…Unlike the rigid version, Artiflex is a foldable lense and only require a 3.2-mm corneal incision to be implanted during the surgical process, even without sutures, potentially affording a lower incidence of surgically induced astigmatism [ 6 ]. Up to now, a number of clinical trials [ 4 , 5 , 7 – 15 ] comparing Artisan with Artiflex PIOLs for moderate to high myopia were conducted to obtain broader and clearer evidence to investigate which one was superior in terms of clinical outcomes from varying aspects. However, no summative conclusions were produced because there were no sufficient qualified studies for systematic analysis, and heterogeneity existed in the outcome indicators and follow-up duration of each study, making the results biased to some extent.…”