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Artiflex an option for mild keratoconus, residual myopia after LASIK, PRK

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LONDON — In some challenging eyes, Ophtec's Artiflex phakic IOL can produce visual results that are comparable with its results in uncomplicated high myopia, according to a surgeon speaking here.

Antonio Marinho, MD, and colleagues compared clinical results with the Artiflex foldable anterior chamber phakic IOL in three conditions: uncomplicated myopia, mild keratoconus and residual myopia after corneal refractive surgery. He presented the results of the study at the European Society of Cataract and Refractive Surgeons meeting.

The myopia-only group included 91 eyes of 52 patients with a mean refractive error of –8.73 D. The mean age of the patients was 30 years, and they were followed for up to 36 months postop, Dr. Marinho said.

The keratoconus group included 11 eyes of seven patients with a mean refractive error of –7 D. The mean age of patients in this group was 29 years. For 10 of these eyes, patients had initially sought corneal refractive surgery, but examiners detected mild keratoconus, making them ineligible for such surgery. One eye had previously been implanted with Intacs ring segments (Addition Technology) for keratoconus, and the Artiflex lens was used to correct residual myopia.

A third group of 13 eyes of nine patients had previously undergone corneal refractive surgery; PRK in 11 eyes and LASIK in two eyes. For these patients, whose mean age was 38 years, residual myopia averaged 5.32 D, but none showed signs of corneal ectasia, Dr. Marinho said.

"Accuracy was comparable in the myopic group and in the keratoconus group, where about 90% of the eyes were plano. It was slightly lower in post-refractive [surgery] group because a number of these patients had a residual astigmatism that could not be treated by further laser surgery," he said.

Phakic IOL calculation was similar for both the keratoconus group and the myopia-only group, Dr. Marinho noted. "But in the post-refractive [surgery] group, we had to aim for a slight myopia, between –0.75 D and –1 D, because if we aimed for emmetropia the result would have been hyperopic," he said.

"Efficacy was comparable in the three groups," he said. Most eyes maintained preoperative best corrected visual acuity, no eyes lost BCVA and some eyes, mainly in the keratoconus group, gained BCVA.