Flexible Toric Iris Claw Phakic Intraocular Lens Implantation for Myopia and Astigmatism

Purpose: To assess the visual and refractive outcomes of flexible toric iris claw phakic intraocular lens implantation for correction of moderate to high myopia with astigmatism. Methods: In this non-randomized prospective study, 31 eyes of 18 patients including 8 male and 10 female subjects with mean age of 27.62±5.53 (range 19 to 38) years with moderate to high myopia and astigmatism underwent toric Artiflex (Ophtec BV, Groningen, Netherlands) phakic intraocular lens (PIOL) implantation. Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were measured in logarithm of minimum angle of resolution (logMAR) notations. Manifest refraction, safety, efficacy, predictability and complications were measured 6 months after surgery. Results: Pre-operatively, mean spherical equivalent (SE) refractive error was -9.68±1.92 (range -14.00 to -6.00) diopter (D) and mean cylinder was -2.79±1.06 (range -4.75 to -1.00) D. After a minimum of 6 months, mean SE was -0.38±0.27 (range -0.87 to 0.00) D and mean cylinder was -0.66±0.43 (range -1.50 to 0.00) D. SE was within 0.50 D of emmetropia in 63.8% and within 1.0 D of target refraction in 100% of eyes. UDVA was equal or better than 20/20 in 45.1% of eyes while CDVA was equal or better than 20/20 in 67.7%; 83.8% of eyes gained 1 or more Snellen lines of CDVA after surgery. No serious complications occurred in this series of cases. Conclusions: Implantation of the toric Artiflex PIOL is a safe and effective procedure for correction of moderate to high myopia with astigmatism.