Clinical observation of late-onset decentration of Artisan Phakic intraocular lens for correction of high myopia

Abstract

Objective To analyze the occurrence of late-onset decentration of Artisan Phakic intraocular lens (PIOL) implanted for correction of high myopia,to increase the long-term rate of normotopia and stability by modification of surgery skills.Methods A more than 3 years (average 4.5 years) retrospective follow-up study.Forty eyes of 20 patients underwent Artisan PIOL implantation for the correction of high myopia.The patients were divided into 2 group base on the difference of surgery method.Group 1 was PIOL implanted in the centre of pupil,Group 2 was PIOL implanted up the centre of pupil.The clinic data (included visual acuity,refraction,PIOL position) of the pre-operation and post-operation were compared,the occurrence of late-onset decentration and the influence on endothelial cell density (ECD) were observed.Results After more than 3 years follow up,34 eyes (87.18％) reached an uncorrected visual acuity (UCVA) of 0.5 or better,40 eyes (100％)kept a best spectacle-corrected visual acuity (BSCVA) of 0.5 or better.The mean spherical equivalent (SE) was-0.34 diopters.There were 30 eyes PIOL had implanted in the center of pupil,more than half of eyes (16 eyes) were found down located position,obvious down located in 6 eyes (mean 0.52±0.12mm),and a little down located in 10 eyes (mean 0.22±0.12mm),in 4 eyes of 3 patients PIOL dislocated form iris,In other 10 eyes PIOL located at the right position while followed-up (mean followed up 4.8 years).There were 10 eyes PIOL had implanted a little up located relative to the pupil (mean up the center 0.38±0.10mm),the PIOL at the right position in 5 eyes while another 5 eyes kept a relative up position of the pupil (mean up the center 0.26±0.13mm),mean followed up 3.4 years.In the group of PIOL located at the right position,a little upper location and a little down location of pupil,the ECD showed safe and stabile,but in the eye PIOL clearly down located of pupil and dislocated of iris,the ECD had decreased in different level.Conclusions Artisan PIOL is well for the correction of high myopia.Late-onset decentration has been observed by long-term follow-up,and followed the decrease of the ECD.Located the Artisan PIOL at a relative upper position of the pupil might anti-gravity induced lower location and kept the PIOL at the perfect position in long term,which can reduce the happening of complication,increase the safety. Key words: Artisan; High Myopia; Decentration; Long-term follow-up