Background and objectives: High myopia is one of the causes of decreased vision in young people that generally corneal refractive surgeries (LASIK or PRK) cannot successfully resolve their problems. In this research efficacy of INTRAOCULAR PHAKIC LENS implantation were evaluated in this group of patients.Materials and methods: In these research results of PHAKIC LENS implantation in 28 eyes of 14 patients with high myopia evaluated. Main outcome measures were refraction, BCVA, UCVA, IOP and pachymetry; which were evaluated at first day, one and six month after operation. Results: Meaningful increase in visual acuity of this patients with and without spectacle correction was seen (P<0.005). No vision threatening complications were seen in these patients. Preoperative and postoperative pachymetries don't show significan changes.Conclusion: That PHAKIC INTRAOCULAR LENS implantation is a suitable procedure in patients whom are not good candidate for keratorefractive surgeries.

Purpose: To evaluate indications, clinic characteristics, and outcomes in a series of patients who underwent explantation of PHAKIC INTRAOCULAR LENS (pIOL). Methods: Retrospective case series of patients who underwent IRIS-CLAW pIOL explantation in our institution from 2018 to 2022. Indications for explantation and visual and refractive outcomes were analyzed. Results: Twenty-three eyes of 14 patients underwent pIOL explantation with a mean time to explantation of 11. 7 ± 3. 4 years. The mean age at explantation was 46. 0 ± 3. 9 years. Sixteen Artisan and seven Artiflex IOL were explanted. The main indication for explantation was endothelial cell loss (n = 14) and morphometric significant alterations of endothelial cells other than endothelial cell count decline (n = 5). The mean corrected vision after explantation was 0. 4 ± 0. 4 logMAR, and around 70% of intervened patients achieved visual acuity of at least 0. 3 logMAR (0. 5 in decimal scale). Conclusions: In our group series, the main reason for the removal of pIOL was endothelial cell loss. This complication should be monitored and followed, so that early actions, namely IOL explantation, can be performed to avoid the development of deterioration requiring corneal transplantation. In fact, loss of follow-up, found in several cases for many years, continues to be a serious problem.

Purpose: To determine and evaluate the visual acuity (VA) and refracion of correcting compound severe myopic astigmatism with the Artisan toric INTRAOCULAR LENSes (IOLs).Methods: In this noncontrolled clinical trial, 15 patients with severe astigmatism and at least 2.0 diopters (D) of astigmatism were enrolled. All patients met the inclusion criteria. Artisan toric IOL implantation was recommended to them, while the procedure and its possible complications were discussed. Preoperative examinations included refraction, uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA) tests, endothelial cell count (ECC), and anterior chamber depth (ACD) measurement. Results: Mean UCVA was 1.57 logMAR preoperatively, and increased to 0.21 logMAR 18 months after surgery (P<0.001). Mean sphere was -7.84 ±3.1D (range, -3 to -15) preoperatively, and changed to 0.04±0.47 D (range, 0.75 to -1.5) 18 months after surgery (P<0.001). Cylinder error showed a statistically significant change from -3.53±1.32 D (range, -1.5 to -6.5) to -0.90±0.90 D (range, 0 to -4.5) during the same period (P<0.001). Mean ECC was 3257.8 cell/mm2 before surgery, and 2761.7 cell/mm2 18 months later (P<0.001). Mean ACD showed reduction from 3.7±0.23 mm preoperatively to 2.9±0.23 mm after surgery (P<0.001). Conclusion: When laser refractive surgery is not an option, correcting severe myopia and astigmatism with the Artisan toric IOL has acceptable results, but it’s possible complications must be kept in mind.

Background: Refractive eye are the most common people eye complaints and there are different ways to refractive correction. In this study we compare the effect of two PHAKIC INTRAOCULAR LENSes, Artiflex versus Implantable Contact LENS (ICL).Methods: In a prospective clinical trial study, 40 eyes of 20 patients who came to ophthalmology clinic to correct their refractive error were examined. In 20 eyes artiflex was inserted randomly and in the other 20 eyes, ICL was inserted. After 6 months uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, INTRAOCULAR pressure (IOP), specular microscopy and anterior uveitis was assessed in both groups.Findings: In this study, there is no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, specular microscopy 6 months after surgery in both groups.40% of eyes in Artiflex group developed anterior chamber reaction 6 months post-operatively but no patient in ICL group. So there is obvious difference in the rate of anterior chamber reaction between these two groups.Conclusion: These two LENSes have similar outcomes except in the incidence rate of anterior chamber reaction that is greater in the artiflex group. So these two LENSes are safe with predictable outcome in treating high myopia.

Background: Refractive surgery is the most rapidly evolving issue in ophthalmology. In this study, we compared the effect of two PHAKIC INTRAOCULAR LENSes, Artisan and Artiflex, in refractive surgery.Methods: In a prospective clinical trial studyd 58 eyes of 29 patients with high myopia were treated by PHAKIC INTRAOCULAR LENSes. Artiflex LENS was used in 24 eyes and Artisan LENS in 34 eyes. Patients were followed up for 6 months. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and refraction were assessed in both groups.Findings: Artiflex LENS had better visual outcomes, but the difference with Artisan LENS was only significant in first two months of follow-up. After 6 months, both groups had similar visual outcomes.Although astigmatism was greater in Artisan group in first three months, refraction in both groups was stable after 6 months and the results were not significantly different between the groups. Adverse reaction was not noticed.Conclusion: Artisan and Artiflex had similar long-term outcomes but refraction and vision establishment occur in a shorter period in Artiflex LENSes.

Purpose: To assess Hoffer correction factor in measurement of axial length (AL) in eyes with PHAKIC IOL implants. Methods: In this descriptive historical cohort study, axial length was measured by ultrasound (US) and IOL Master in both PHAKIC and pseudoPHAKIC modes in 24 eyes of 14 patients with Artisan INTRAOCULAR LENSes (IOLs) implanted for refractive purposes, Hoffer's suggested formula for correcting ultrasound AL was applied to the data (cor-US) and all four datasets were compared to preoperative ultrasound AL values as standards.Results: The mean difference between preoperative ultrasound measurements and postoperative readings by US (ALpo), IOLMaster in PHAKIC mode (AL IOLMp), IOL Master in pesudoPHAKIC mode (AL IOLMpp) and US corrected with Hoffer factor (ALhc), were 0.01, 0.022, 0.13, and 0.61mm, with mean absolute differences of 0.23, 0.23, 0.26, and 0.25mm, respectively. In these readings, respectively 42.3%, 37.5%, 57.5%, and 46.2% of differences were greater than 0.2 mm, which is considered to be clinically important. Discussion: Use of the Hoffer correction factor has no clinical application for a more accurate biometry in patients with an Artisan implant. The most reliable method in this type of patients is making an accurate record of their preoperative AL measured with ultrasound or IOL Master.

Purpose: To evaluate the outcome of IRIS-CLAW PHAKIC INTRAOCULAR LENS (PIOL) implantation for high myopia in a subspecialty training setting. Methods: IRIS-CLAW PHAKIC Artisan (Ophtec B.V., Groningen, The Netherlands) INTRAOCULAR LENS implanted patients were invited for an evaluation visit: 83 eyes had been operated on by a group of 10 cornea fellows under the supervision of nine anterior segment faculty members during 2005-2006. Postoperative time course ranged from four to 38 months. The outcome was assessed in those who participated in the evaluation visit (50 eyes collectively). Results: Evaluation visit uncorrected visual acuity (UCVA) was equal to or better than preoperative best spectacle corrected visual acuity (BSCVA) in 68% of the eyes; mean BSCVA had improved significantly (equivalent to two Snellen lines; P<0.004). Residual spherical equivalent (SE) was within ±1.00 diopter (D) in 68% and ±2.00 D in 92%; eyes with longer postoperative time courses (>10 months) were on average 0.94 D more myopic (P=0.007). No eye had lost BSCVA. No major complication like retinal detachment or cataract had happened. Better UCVA was predictable by shorter postoperative time course, milder baseline myopia, and better baseline BSCVA (P<0.004).Conclusion: IRIS-CLAW PIOL implantation for high myopia was found efficacious and safe in subspecialty training. A noticeable myopic drift was observed, and refractive predictability was not as favorable as expected. Induced astigmatism, miscalculation, mislabeling/wrong refraction, and myopic progression could have been responsible for >2.00 D residual SE in four eyes.

Purpose: To compare changes in anterior segment biometric properties after implantation of conventional posterior chamber PHAKIC INTRAOCULAR collamer LENS (ICL) versus Aquaport posterior chamber PHAKIC ICL.Methods: The records of myopic patients who underwent ICL implantation between March 2012 and April 2015 were reviewed. Patients’ demographic data, manifest and cycloplegic refraction, best-corrected visual acuity (BCVA), and INTRAOCULAR pressure (IOP) were recorded preoperatively. All patients underwent ultrasonic bio microscopy (UBM; STS, Quantel Medical, France) under dim light conditions to determine anterior segment biometric properties including sulcus-to-sulcus distance and iridocorneal angle parameters. Corneal tomography (Galilei dual Scheimpflug analyzer, Ziemer, Switzerland) was used to obtain corneal curvature and elevation data. The same measurements were obtained postoperatively to determine and compare changes in biometric parameters between two types of ICL.Results: Overall, 58 eyes of 30 myopic patients were enrolled in this study. Of which, 28 eyes of 15 patients were implanted with V4b ICL and 30 eyes of 15 patients received V4c ICL. The mean follow up time was 27.7 ± 9.3 and 26.6 ± 8.8 months in the V4b and V4c groups, respectively. There was no significant difference in postoperative refraction results and IOP between groups at 1 and 3 postoperative months. Compared to preoperative values, all anterior segment biometric parameters were changed in both groups postoperatively. Nasal angle parameters (TIA, AOD500) were significantly different between the V4b and V4c groups. The two study groups were comparable in other biometric parameters and LENS densitometry postoperatively.Conclusion: The presence of central hole (Aquaport®) in V4c ICL is as effective as performing peripheral iridotomy in V4 ICL LENSes in preventing further deterioration of anterior segment biometric parameters and may provide more uniform flow of aqueous humor to the anterior chamber angle.

Purpose: To compare the visual outcomes and complications of three different types of PHAKIC INTRAOCULAR LENSes (PIOLs), for correction of moderate to high myopia.Methods: We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer LENS (ICL, 36 eyes). Best corrected visual acuity (BCVA), INTRAOCULAR pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared.Results: Mean follow‑up period was 30±11 months. Preoperatively, spherical equivalent (SE) refractive error was -1.6±3.7, −.59±1.97, and −2.3±4.8 D in the Artisan, Artiflex and ICL groups, respectively.SE was comparable among the study groups at final follow‑p (P=0.237). Mean astigmatic reduction was 0.31±0.72, 0.45±0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P=0.007).Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P=0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P=0.158); pachymetric changes were minimal with no difference among the three groups (P=0.754), and mean CEC loss was 10±9%, 9± 6% and 9±10% in the Artisan, Artiflex and ICL groups, respectively (P=0.694). HOAs (P=0.039), vertical trefoil (P=0.032) and spherical aberration (P=0.001) were higher with Artisan group as compared to ICL. Total aberrations (P=0.028) and spherical aberration (P=0.001) was also higher with Artisan group as compared to Artiflex.Conclusion: Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.