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Same advantages, smaller incision with Artiflex IOL
The foldable version is showing all the advantages of the PMMA Artisan without the large incision.
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PORTO, Portugal – The Ophtec Artiflex lens offers refractive surgeons another option in foldable phakic IOLs, according a presentation here.
Antonio A. Marinho, MD, PhD, discussed the Artiflex within the framework of current phakic IOL options at the American Society of Cataract and Refractive Surgery meeting. Although at the time he had only preliminary experience with the Artiflex in two patients, Dr. Marinho was cautiously optimistic about the IOL’s potential for phakic implantation.
He said the anterior chamber offers a larger space to place a phakic IOL than the posterior chamber, and because of the new silicone lens material used in the Artiflex there is not as much endothelial concern as in the past, nor the same level of risk of cataract formation.
Surgeons still have the choice of a small or large incision for anterior chamber phakic IOLs, Dr. Marinho said, but the latter will induce astigmatism, the level of which will depend on the skill of the surgeon. Topical anesthesia can also pose a problem with incisions that are 5 or 6 mm in size. With a small incision, however, there is no risk of astigmatism and topical anesthesia can be used, he said.
Surgeons also have a choice regarding fixation of anterior chamber IOLs in the angle or in the peripheral iris, he said.
“If we go to the angle, we have sizing problems leading to decentration and pupil distortion. However, if we do an iris fixation, one size fits all, and if we do a good surgery, we almost have no complications,” he said.
“With a small incision, you do not have astigmatism, but there are size-related problems with some decentration, that although not the fault of the lens or the surgical procedure, results because the pupil is not centered with the cornea, something that is unavoidable,” said Dr. Marinho, a professor of ophthalmology at the Instituto Ciencias Biomedicas in Porto, Portugal.
Foldable version
Dr. Marinho said the foldable Artiflex iris-fixated phakic IOL has a 6-mm optical zone, a soft silicone optic and PMMA haptics. It is the same size as the rigid Artisan.
Because he had only 2 to 3 weeks follow-up in two patients at the time of his presentation, Dr. Marinho was unable to report long-term patient results.
He described the surgical procedure for Artiflex implantation. A paracentesis is created at 10 o’clock and 2 o’clock, just as in surgery for the rigid Artisan. A spatula is used, allowing a slow, controlled entrance of the lens through a 3.2-mm incision. The lens then unfolds itself without contact with the corneal endothelium. Once it is inside, the spatula is disengaged and removed.
Dr. Marinho said his second patient was aphakic. He said basically the same technique was used, although the incision had to be a little larger, about 4 mm, because the lens was bulkier than for a myopic patient.
Dr. Marinho is positive regarding the advantages of the Artiflex.
“Will the Artiflex be the standard for the future of phakic IOLs?” he asked. “We do not know. It is a nice procedure, and of course we are still in the learning curve.”
For Your Information:
- Antonio A. Marinho, MD, PhD, can be reached at Rua Eugenio de Castro, 170- 41 Porto, 4100-225 Portugal; (351) 22-200-0692; fax: (351) 22-609-3345; e-mail: marin@mail.telepac.pt. Dr. Marinho has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.
- Ophtec BV, manufacturer of the Artiflex Lens, can be reached at Ophtec BV, Sohweitzerlaan 15, 9728 NR Groningen, The Netherlands; (31) 50-525-1944; fax: (31) 50-525-4386; or at Ophtec USA, 6421 Congress Ave., Suite 112, Boca Raton, FL 33487; (561) 989-8767; fax: (561) 989-9744; e-mail: ophtecusa@aol.com; Web site: www.ophtec.com