Phakic IOL has good outcomes but higher endothelial cell loss than previous studies

Placement of the Artisan phakic IOL is predictable, stable and effective for reducing high and extreme levels of myopia at 5 years follow-up, according to a prospective study by researchers in California. However, the study authors advised caution when considering implanting these phakic IOLs in young patients or in patients with compromised endothelial cell counts.

"The rate of endothelial cell loss was significantly higher than has been reported in previous studies," they said.

Edward E. Manche, MD, and colleagues at Stanford University School of Medicine evaluated safety, efficacy, predictability and 5-year stability outcomes after implanting the Artisan phakic IOL (Ophtec) in 26 eyes of 15 patients with high and extreme myopia. Preoperative spherical equivalent averaged –12.3 D, and endothelial cell density averaged 2,481 cells/mm².

At 5 years, manifest refraction averaged –0.37 D, with 95% of eyes within 1 D of attempted correction and 74% of eyes within 0.5 D of attempted correction, the authors noted.

Uncorrected visual acuity of 20/40 or better was achieved by 95% of eyes; 74% achieved an uncorrected visual acuity of 20/20 or better.

No eyes experienced a loss of one or more lines of best corrected visual acuity, and 16% of eyes gained two or more lines of BCVA.

However, endothelial cell density averaged 2,156 cells/mm² at 5 years follow-up, representing a 14.05% decrease from the average value at baseline (P = .01), according to the study, published in the June issue of Archives of Ophthalmology.

Advanced Medical Optics markets the Artisan IOL in the United States under the trade name Verisyse.