Iris-fixated toric phakic intraocular lens for myopic astigmatism

PURPOSE: To evaluate the efficacy, predictability, safety, stability, and complications of the Artiflex toric iris-fixated phakic intraocular lens (pIOL) for myopic astigmatism. SETTING: Private practice surgery centers, Valencia and Terrassa, Spain. DESIGN: Cohort study. METHODS: At 12 months, refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, complications, pIOL misalignment, and endothelial cell count (ECC) were evaluated. Indices of success and misalignment were calculated using vector analysis. RESULTS: The study enrolled 42 eyes in 25 patients aged 21 to 39 years. The mean spherical equivalent decreased from -8.85 diopters (D) +/- 2.71 (SD) to -0.37 +/- 0.46 D, with 66.7% of the eyes within +/- 0.50 D. The mean cylinder power decreased from -2.90 D (range -1.50 to -5.00 D) to -0.39 D (range 0.00 to -1.50 D); refraction was highly stable. All eyes achieved a decimal UDVA of 0.5 or better and a CDVA of 0.8 or better. A gain of 1 line or more of CDVA was found in 69.1% of eyes. The mean clinical pIOL misalignment was 2.6 +/- 1.8 degrees; 1 eye (2.4%) required surgical repositioning of the pIOL. The mean ECC decrease was 9.3% +/- 1.8%; iris pigment precipitates were observed in 16.7% of eyes. Vector analysis showed excellent mean indices of success for overall (0.94 +/- 0.04), spherical (0.96 +/- 0.05), and astigmatic (0.95 +/- 0.16) corrections; the mean angle of error was 1.8 +/- 2.7 degrees. CONCLUSION: Implantation of the toric pIOL was effective, predictable, safe, and stable for the correction of myopic astigmatism.