Effect of incision types for Artisan phakic intraocular lens implantation on ocular higher order aberrations

AIM： To evaluate the effect of incision types for Artisan phakic intraocular lens （PIOL） implantation on ocular higher-order aberrations （HOAs）.METHODS： A retrospective review was conducted of the patients who had undergone Artisan PIOL implantation for the correction of myopia and followed up for at least 6mo. Patients are classified into 2 groups considering the incision type： cornea group with patients undergone clear corneal incision; sclera group with patients undergone sclera tunnel incision. All patients with postoperative astigmatism of under 1 diopter （D） were included to minimize the effect of residual astigmatism on postoperative HOAs. Visual acuity, special equivalents, astigmatism, predictability （±1 D from target refraction）, HOAs （coma, trefoil, spherical aberration）, and corneal endothelial counts were analyzed preoperatively and 6mo postoperatively.RESULTS： At the postoperative 6mo, all patients of both groups achieved uncorrected visual acuity of 16/20 or better, and significantly decreased the spherical equivalents compared with preoperative values. The predictability of refractive correction was 96% in the former, and 94% in the latter. Unlike the sclera group, preoperative astigmatism decreased significantly in cornea group at postoperative 6mo. The HOAs increased significantly at postoperative 6mo compared to the preoperative values in both groups, and the root mean square （RMS） total and trefoil wavefront aberration of cornea group were significantly higher than those of sclera group.CONCLUSION： Although corneal incision significantly reduces preexisting astigmatism, the postoperative 6mo of total RMS and trefoil aberration change may deteriorate the visual quality after Artisan PIOL implantation.

Coreoplasty and Artisan Intraocular Lens Implantation for Mydriasis and Aphakic Correction in Post-traumatic Vitrectomized Eyes

Purpose:.To evaluate the efficacy and safety of using coreoplasty,.and an iris-supported Artisan intraocular lens (IOL), for mydriasis and aphakic correction in post-traumatic vitrectomized eyes. Methods:.A total of 17 aphakic patients were admitted between April 2009 and April 2010 to the ophthalmologic department of Xiamen Eye Centre..All eyes had previously received lens removal and vitrectomy. After the retina stabilized and corrected visual acuity improved,.the iris was sutured. The Artisan IOL was fixated onto the iris surface..Patients were followed-up at one day, one week,.one month and three months postoperatively..The following outcomes were assessed: symptoms of photophobia and glare, uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), endothelial cell density (ECD). The diameter of pupil and the anterior chamber depth (ACD) were measured by the anterior segment optical coherence tomography (OCT). Results:.Artisan IOLs were successfully implanted in all aphakic eyes. Postoperatively, improvement was observed in photophobia and glare symptoms..UCVA was enhanced in all patients.(six eyes had better UCVA postoperatively than BCVA preoperatively)..However,.there were no significant changes in IOP. Mean loss of ECD was 336.06/mm2. Mean postoperative pupil diameter was 3.67±0.41 mm, compared with 5.67±0.57 mm preoperatively(P<0.05). Mean ACD was reduced by 0.88 mm.(3.38±0.33 mm preoperatively vs 2.50±0.35 mm postoperatively, P<0.05). Conclusion:.Surgery that combined coreoplasty and Artisan IOL implantation was a safe and effective treatment for correcting aphakia and mydriasis in post-traumatic vitrectomized eyes.

Artisan虹膜夹型人工晶状体Ⅰ期植入术的临床观察

目的:观察Artisan虹膜夹型人工晶状体Ⅰ期植入术治疗白内障伴晶状体大范围脱位的临床疗效。方法:收集本院2007-05/2011-12期间白内障伴晶状体半脱位(由外伤、Marfan氏综合征引起)的患者24例28眼,其中4例8眼为Marfan氏综合征引起的晶状体大范围脱位,其余均为外伤引起的脱位,均行超声乳化白内障吸出术或前段玻璃体切除并Ⅰ期植入Artisan虹膜夹型人工晶状体。术后观察视力、角膜内皮细胞计数、人工晶状体位置和术后并发症。随访时间为6mo。结果:与术前比较,术后最佳矫正视力均有不同程度的提高,术后视力0.1～者20眼,0.5～1.0者8眼,随访1～6mo,没有出现人工晶状体移位、虹膜炎症、虹膜萎缩及角膜失代偿等并发症。结论:白内障伴晶状体大范围脱位手术难度大,但只要术者有丰富的临床经验和高超娴熟的技能,仍可行超声乳化白内障吸出术或前段玻璃体切除并Ⅰ期Artisan虹膜夹型人工晶状体植入术并取得较好的手术效果。

硬性和可折叠前虹膜固定人工晶状体植入治疗亚洲眼高度近视的疗效比较

目的:比较Artisan和Artiflex有晶状体眼人工晶状体(PIOL)矫正亚洲人群高度近视的屈光度和安全性。方法:历史队列研究。回顾2016/2020在印度尼西亚日惹市Yap眼科医院接受PIOL植入术的81例高度近视眼。根据植入PIOL分为Artisan组43眼,Artiflex组38眼。分别记录术前及术后1d、1、3mo的视力、角膜生物显微镜参数和眼压,包括术前前房深度。结果:Artisan和Artiflex组的平均随访时间分别为9.64±6.93mo和8.96±4.28mo(P=0.736)。Artisan组的疗效指数为1.03±0.47,Artiflex组为1.02±0.17(P=0.119);安全性指数分别为1.10±0.45和1.05±0.21(P<0.001)。Artisan组的平均等效球镜度(SE)为-0.64±0.996D,Artiflex组为-0.22±0.58D(P=0.076)。两组术后内皮细胞密度(ECD)较术前均显著下降(P<0.05),累积ECD缺失率为7.44%和5.79%(P=0.418)。结论:Artisan和Artiflex矫正亚洲人高度近视的屈光效果相当。与Artiflex相比,Artisan的安全指数略高,而两组的疗效指数和累积ECD缺失率相似。

Artisan人工晶状体植入矫正玻璃体切除术后无晶状体眼的临床观察

目的观察晶状体玻璃体切除术后眼内二期植入Artisan晶状体的有效性、可预测性和安全性。方法回顾性分析16例因各种眼外伤行晶状体、玻璃体切除术后二期植入Artisan晶状体的病人。观察指标包括：手术时间，术前及术后的裸眼及矫正视力，屈光度，角膜内皮细胞计数，术中术后并发症。随访时间（26．3±3．6）个月。结果平均眼轴（22．46±0．47）mm，手术经历时间15～36min，平均（17．3±4．4）min。术中有12例病人人工晶状体近水平放置，4例病人斜向放置。所有病人术后裸眼视力均较术前提高，术后6个月，裸眼视力等于术前最佳矫正视力的有6例，0．3及以上者13例，0．2者2例，0．1者1例。手术预留屈光度为轻度近视（-0．5D），术前与术后6个月屈光度对比，球镜屈光度：术前（＋10．2±1．09）D，术后：（-0．63±0．44）D（P〈0．05）；柱镜屈光度（绝对值），术前：（1．84±1．56）D，术后：（1．97±1．69）D（P〉0．05）。4例斜向放置病人术后平均球镜屈光度为一0．75D。柱镜屈光度（绝对值），术前1．94D，术后1．75D。术前角膜内皮细胞计数（2377．4±279．74）个／mm2，术后1年角膜内皮细胞计数均数为（2265．7±258．65）个／mm2，损失率为4．7％；术后2年平均为（2244．4±249．32）个／mm2，第2年损失率为0．94％。并发症：2例病人少量前房出血，3例病人一过性角膜水肿，3例病人术后低眼压（〈8mmHg），其中1例病人伴视物晃动感，上述并发症均于1周内恢复。未观察到其它并发症。结论晶状体玻璃体切除术后二期植入Artisan晶状体有效性、预测性良好，2年随访有较好安全性。