JAN VENTER MD

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Artisan Phakic IOL
JAN VENTER MD Optimax, laser eye
specialists London, UK
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Prediction for theFuture

• ? Phakic IOLs will increase
• ? LASIK will decrease
• ? Both will improve

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Normal Optics
? Closer to Nodal point better quality
vision ? Cornea Disadvantages ? Optical
correction needs to go inside the eye
Cornea
Lens
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Problems With Corneal Procedures

• Flap Induced aberrations
• Small ablations (night vision problems)
• - Eccentric ablation (diplopia)
• - Abnormal beam profile (lines loss)

? Distance from Nodal point ? Optical Problems
with LASIK
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Anatomical Problems
LASIK
? Corneal Ectasia ? Irreversable
Phakic IOL

? Minimal alterations in Optical
aberrations ? Minimal anatomical problems
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Artisan Advantages
? One size fits all ? Pupil Centration ? Myopia
Hyperopia - Astigmatism
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Artisan Disadvantages
? 5mm OZ Toric Glare ? PMMA 5 or 6mm
OZ 5.2 6.2mm incision ? Iris fixation
long term ? Claw disengagements ? ? Flare
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Anatomical Position
Endothelium IOL 2mm IOL Crystalline lens
0.5mm Endothelial cell count no ?
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Hyperopia
(75 eyes)
Mean age 38 years (from 22 to 54)
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Refractive outcome
87 within ? 1 D 65 within ? 0.5 D
pre SR equiv mean 5.88 D 1.57 D (from 2.50 to
10.00) post SR equiv mean -0.25 D 0.57 D (from
-2.00 to 1.25)
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Predictability
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Stability
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Efficacy
88 0.5 or better 22 1.0 or better
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Safety
35 gained 1 line or more 8 gained 2 lines or
more
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Myopia
(274 eyes)
Mean age 38 years (from 21 to 68)
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Refractive outcome
90 within ? 1 D 61 within ? 0.5 D
pre SR equiv mean -11.05 D 3.62 D (from
-24.00 to -4.13) post SR equiv mean -0.32 D
0.51 D (from -2.13 to 1.25)
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Predictability
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Stability
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Efficacy
94 0.5 or better 29 1.0 or better
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Safety
36 gained 1 line 20 gained 2 lines or more
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Toric Artisan lens Technical Specs
Overall diameter 8.5mm
Lens Width 5.0mm Optical
Diameter 5.0mm Height 1.04mm
Weight 10 OMG in Air Available
Powers Myopia -2.00 to -20.00D
Cylindrical Correction -1.00 to -7.00D
Hyperopia 2.00 to 12.00D Cylindrical
Correction -1.00 to -7.00D
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Artisan Toric
(136 eyes)
Mean age 38 years (from 17 to 59)
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Refractive outcome
91 within ? 1 D 72 within ? 0.5 D
pre SR equiv mean -10.31 D 4.46 D (from
-22.25 to 7.13) post SR equiv mean -0.20 D
0.48 D (from -2.125 to 2.625)
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Predictability
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Stability
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Efficacy
84 0.5 or better 25 1.0 or better
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Safety
55 gained 1 line or more 21 gained 2 lines or
more
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Endothelial cell count
Average endothelial cell count Pre-op 2809
cells/mm2 ? 555 Standard deviation Post-op
2988 cells/mm2 ? 514 Standard deviation
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Surgical Complications
Remove Artisan 2 Pupil block glaucoma 1
Additional treatment 15 Shallow A/C 10
Hyphema
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Conclusion
The predictability, efficacy and safety
were excellent in all 485 eyes implanted with
Artisan lens The resulting correction of
astigmatism is better than any Phakic IOL
currently available
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Conclusion
This is the first choice in Phakic IOLs
for correction of combined Myopia, Hyperopia and
astigmatism The new foldable Artiflex will allow
implantation through a 3.2mm incision. Will only
correct myopia. Toric Artiflex trial to start
early in New year
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Thank you
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Different Meanings of 20/20
P-IOL, Acuvue, Spectacles20/20, high contrast
acuity
Wavefront LASIK20/20, medium contrast acuity
Standard LASIK20/20, low contrast acuity
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