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Comparison of phakic intraocular lenses Artisan and Artiflex in terms of efficacy, safety and patient satisfaction

Poster Details

First Author: N.Quesnel CANADA

Co Author(s):    L. Lalonde   S. Sabas   C. Serhan        

Abstract Details


To determine if there is a difference between Artisan and Artiflex in terms of efficacy of myopia correction, postoperative uncorrected visual acuity, endothelial cell loss and patients satisfaction as assessed by a questionnaire.


IRIS Ophthalmology Clinic / University of Montreal, Quebec, Canada


This prospective study included 26 myopic patients aged 33.78±6.15 years who underwent binocular implantation of an iris-fixated phakic intraocular lens (pIOL) for correction of myopia with or without astigmatism. Ten patients received an Artisan and 16 underwent implantation of an Artiflex pIOL (Ophtec BV, Groningen, The Netherlands). All pIOL implantations were performed by the same experienced surgeon (LL). The mean preoperative spherical equivalent was -10.28±2.55 diopters (D) (range -6.50 to -15.75 D). Pre and postoperative (3 months and 12 months) visual acuity (LogMar), refractive error, endothelial cell density (ECD) (Topcon SP-3000P specular microscope) were computed. The mean preoperative data were similar between the 2 groups (Artisan and Artiflex). At one year post-op, to subjectively evaluate visual symptoms such as halos and glare, patients responded to a self-administered psychometric questionnaire consisting of 10 questions related to their quality of vision, their need for glasses for daily activities and satisfaction following the surgery. The number of patients who experienced complications or who underwent LASIK for residual ametropia was also computed. Statistical analysis was performed using SPSS software (version17.0). The Pearson linear correlation coefficient (r) was used to test relations between variables. Two factors (pIOL * time) ANOVA were also computed.


At one year postoperative, there is no statistically significant difference between the 2 pIOL for mean uncorrected visual acuity (LogMAR 0.13 or 6/7.5-3), mean best corrected visual acuity (LogMAR 0.03 or 6/6-2), mean residual spherical equivalent (-0.13 ±0.42 D) and decrease in ECD. However, the effect of time is a significant factor (ANOVA) for visual acuity (F3,63 = 2.878) and ECD (F1, 24 = 12.261). From preoperative measurements, the mean ECD decrease by 7% for the Artisan compared to 9% for the Artiflex at one year postoperatively. This change is statistically significant (p<0.05) for both lenses. Four patients, 2 implanted with the Artisan and 2 with the Artiflex required a Lasik enhancement but no patient required glasses. No eye experienced a loss of 1 or more lines of best-corrected visual acuity. Two eyes implanted with the Artiflex and one with the Artisan gained 1 or more lines of best-corrected visual acuity. For both pIOL there is no significant correlation between the level of satisfaction and residual refractive error, visual symptoms (glare and halos), pre or postoperative refractive error. All patients but one (Artiflex) will opted for the same surgical procedure and pIOL if they have to do it again.


According to this study, one year after implantation, Artisan and Artiflex pIOLs show no difference in visual performance, efficacy, safety and patientÂ’s satisfaction despite their differences in optic material and surgical procedure (incision length and position). PatientÂ’s satisfaction is very high for both pIOLs since 96% of patients will choose the same pIOL and surgical procedure to correct their myopia. Further studies should include more patients and longer follow-up. FINANCIAL DISCLOSURE?: No

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