Retrospective Analysis Of Surgical Outcomes And Complications After Secondary Artisan Lens Implantation

Complicated cataract surgery and IOL luxation are two of the most frequent causes of aphakia, which require secondary surgical interventions for visual rehabilitation. A popular technique is retropupillary implantation of an aphakia Artisan intraocular lens (IOL) combined with pars plana vitrectomy (PPV) as the surgical technique is standardizable and leads to good anatomic and functional results. Nonetheless, long-term complications such as cystoid macular edema often compromise the functional outcome. This study aims to evaluate the safety and efficacy of this surgical approach in aphakic eyes after complicated cataract surgery and in eyes with IOL or crystalline lens dislocation.

 Outcome measures at three months postoperative included best-corrected visual acuity (BCVA), refractive outcome, presence of complications such as intraocular pressure (IOP) rise, corneal decompensation, pupil ovalization, cystoid macular edema, need for multiple surgical interventions.

A total of 153 eyes from 149 patients were analyzed. Follow-up ranged from 1 to 42 months, mean 10.9 months. The commonest cause of aphakia was IOL dislocation in 100 of 153 eyes (65.5%). After 3 months, best corrected visual acuity increased by 0.24. Mean spherical equivalent was -0.65 dioptres at 3 months. There were few post-operative complications, the most frequent being cystoid macular edema, which mostly resolved spontaneously or with topical treatment.

Artisan lens implantation is an effective and safe treatment modality for IOL dislocation with satisfactory improvement of visual acuity and refractive error within three months after surgery. CME as a possible complication of Artisan lens implantation can be well controlled with topical treatments.