Artiplus Phakic IOL Expands Treatment Options

The Artiplus phakic IOL (Ophtec) yielded good refractive and visual acuity outcomes at the two-year mark in presbyopic patients, an international multicentre study suggests.

The lens is the multifocal successor to the Artiflex, with a multisegmented refractive optic on the posterior surface to minimise dysphotopsias and a reading add power of +2.50 D. According to Robin Ollivier MD, iris fixation prevents the biggest challenge facing phakic multifocal IOLs, especially those in the posterior chamber: centration.

“As the lens is fixated on the iris, it grants maximum stability,” she clarified.

The optical design includes continuous transitional focus technology, providing a full range of vision with a smooth transition, and is available in both toric and non-toric versions for myopia and hyperopia, which is quite unique.

The lens needs a pre- or intraoperative peripheral iridectomy to avoid any intraocular pressure (IOP) rise, and the surgical procedure for the implantation is straightforward, requiring only 5 to 15 minutes depending on the peripheral iridectomy.

The international multicentred study, led by Professor José Luis Güell and conducted in nine centres across Europe and South Korea, involved 49 patients implanted with Artiplus in both eyes (98 eyes). It was an open label, prospective and non-controlled study with a follow-up period of three years.

Patients selected were presbyopic adults requiring at least +1.00 D reading glasses and with good ocular health. The study was performed on the non-toric model, so the expected postoperative refractive cylinder would be ≤ 0.75 D. The minimal anterior chamber depth was 2.8 mm from the corneal endothelium, and other implantation criteria, like the endothelial cell count, were in line with those of iris-fixated phakic IOLs.

The refractive result remained stable after two years, with a mean of -0.25 D. Visual acuity in logMAR was 0.04 for far, near, and intermediate vision, both monocularly and binocularly. Around 90% of patients achieved uncorrected visual acuity of 20/25 for distance, intermediate, and near vision, with potential correction up to 20/20 vision. The defocus curve showed a smooth transition from far to near vision, and contrast sensitivity remained unchanged pre- and postoperatively.

After surgery, 91% of patients no longer needed glasses while 9% required glasses occasionally for distance, intermediate, or near vision. The mean endothelial cell count loss was -0.6%, aligning with expected annual levels. Patient satisfaction questionnaires returned ‘very’ to ‘quite’ positive results, with minimal reports of glare, halos, and starbursts, which were reported as not bothersome. Adverse events included dry eye, two cases of transient high IOP, one case of mild viral conjunctivitis, one case of non-pathological guttata, one case of an optic neuritis unrelated to the Artiplus, and three cases of mild inflammatory deposits on the IOL treated with topical steroids.

The two-year interim results were excellent, with investigators highly satisfied with the lens’s safety and efficacy for presbyopia correction.

“It is a reversible procedure. Patient- and surgeon-reported outcomes are very positive,” Dr Ollivier concluded.

Dr Ollivier spoke at the 2026 ESCRS Winter Meeting in Helsinki.

Robin Ollivier MD is a cataract and refractive surgeon at the University of Maastricht, Netherlands.