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Comparative study of the outcomes of two toric phakic intraocular lenses in the correction of myopic astigmatism: ICL® vs Artiflex®

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Session Details

Session Title: Phakic IOLs II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 14:30

Venue: Room 17

First Author: : C.Vale PORTUGAL

Co Author(s): :    R. Massa   A. Figueiredo   M. Furtado   M. Lume   R. Salgado   M. Brochado     

Abstract Details


The aim of this study was to evaluate and compare the functional and refractive outcomes of the implantation of two toric phakic intraocular lens (IOL) for the correction of myopic astigmatism.


Department of Ophthalmology, Hospital de Santo António - Centro Hospitalar do Porto, EPE. Oporto, Portugal


Retrospective study of 61 eyes divided in two groups: Group 1: 30 eyes of 21 patients implanted with toric ICL v4c® IOL, mean age of 32 years old (y.o), mean follow-up of 16 months; Group 2: 31 eyes of 19 patients implanted with Artiflex® toric IOL, mean age of 35 y.o and mean follow-up of 20 months. Patients underwent extensive examination, including uncorrected (UCVA) and best-spectacle corrected visual acuities (BCVA), tomographic evaluation (OrbscanII® and PentacamHR®), endothelial cell density (ECC) and morphology (ICONAN®). Ultrasound biomicroscopy performed in Group1. Target postoperative spherical equivalent (sEq) was emmetropia. Clinical outcomes were compared between groups.


Group1: sEq reduced to -0.34±0.5D from -10.61±3.9D(P=0.00). Postoperative-UCVA better than preoperative-BCVA (0.12 logMar±0.12 vs. 0.19logMar±0.17,P=0.032). Efficacy and safety index of 1.14 and 1.28. ECC reduced to 2955 from 3123 (P=0.002). Vault between 100-1250µm. 2 IOL-rotations ≥30º. 3 eyes underwent laser surgery; Group2: sEq reduced to -0.24±0.45D from -7.5±3.9D,(P=0.00). Postoperative-UCVA better than preoperative-BCVA (0.05logMar±0.08 vs. 0.13logMar±0.12,P=0.00). Efficacy and safety index of 1.17 and 1.26. 16% of pigmented precipitates, one traumatic haptic subluxation surgically resolved. Postoperative-UCVA better in Group2(P=0.03). 68% of eyes in Artiflex®group achieved emmetropia vs. 33% in ICL®group(P=0.01). No lines of BCVA lost. ACD was significantly reduced in both groups.


Both toric intraocular lenses appears to have good performance regarding efficacy and safety in the correction of moderate to high myopic astigmatism and can allow spectacle-independence for distance vision. However, Artiflex® appears to have more predictability. As long as patients are carefully selected there are no major safety-concerned complications with both IOLs. Careful preoperative work - up is warranted for optimizing correct sizing of the Visian ICL® and a more strict postoperative screening of IOL position seems to be of great value.

Financial Interest:


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