Comparison Of Long-Term Efficacy And Safety Results Of Cachet® And Artiflex® Phakic Lenses

Evaluation and comparison at 5 and 10 years postoperatively of refractive and safety parameters between Acrysof Cachet^® and Artiflex^® anterior chamber phakic lenses.

Phakic intraocular lenses allow correction of moderate to high myopia with excellent levels of efficacy, safety, stability and refractive predictability. Progressive endothelial loss is a serious medium to long-term complication associated with phakic lenses implanted in the anterior chamber. The AcrySof Cachet^® lens was discontinued from the market in 2014 due to an association with severe endothelial loss.

Retrospective and comparative study of patients undergoing Cachet^® and Artiflex^® lens implantation surgery for treatment of myopia at Hospital de Braga. Inclusion criteria: age >20 years, stable refraction >12 months, primary procedure with no previous eye surgeries.

Forty eyes of 24 patients undergoing Cachet^® lens implantation and 91 eyes of 50 patients with Artiflex^® lens were evaluated. At 5 years, the safety and efficacy index were similar in the two groups (p=0.612; p=0.423, respectively); At 10 years, both indexes were higher in the Cachet^® group (p=0.010; p=0.013, respectively). The SE correction rate was higher in the Cachet^® group at 5 years (p=0.016); with no significant differences at 10 years (p=0.115). There was a significant decrease in endothelial cell density in both groups along the follow-up; without significant differences between them at 5 (p=0.607) and at 10 years (p=0.592). A total of 4 (10%) Cachet^® lens and 1 (1.1%) Artiflex^® lens explantation (p=0.049) were reported.

The Acrysof Cachet® lens demonstrated a safety and efficacy index similar to the Artiflex® anterior chamber phakic lens. Any patient with a phakic lens should be monitored annually to prevent complications such as severe endothelial loss and loss of corneal transparency.