Optical quality of the eye with the Artisan phakic lens for the correction of high myopia

Purpose. To evaluate the optical quality of the eye before and after the insertion of an Artisan phakic intraocular lens for the treatment of high myopia. Methods. Consecutive patients implanted with the Artisan lens by a single surgeon between June 2001 and April 2002 were enrolled prospectively. One eye per subject was tested. The wavefront aberration was calculated from images recorded with a Hartmann-Shack sensor. This wavefront aberration was expressed as a Zernike polynomial expansion from the third up to the seventh order. Root mean square wavefront error was used as a parameter of optical quality. Point-spread function and modulation transfer function were also computed from the wavefront aberration. Results. The mean age of the four patients (four eyes) was 46 +/- 11 years. The preoperative mean spherical equivalent was -14.13 +/- 3.19 D (range, -20.50 to -9.75 D), with a best-corrected visual acuity of 20/25 or better in three of the four eyes. No complications were encountered. Postoperatively, the mean spherical equivalent was -0.22 +/- 0.30 D (range, -0.75 to +038 D). An uncorrected visual acuity of 20/40 or better was observed in three eyes. Overall, for each combination of order (third, fourth, and fifth to seventh) and pupil size (3, 4, and 5 mm), the mean postoperative root mean square values for the four subjects were lower than the mean preoperative values. However, because of the small size of the study population (four patients), this improvement did not reach a statistically significant level. Conclusion. Preliminary data using the Hartmann-Shack wavefront sensor have not revealed a tendency toward deterioration of the optical performance after the insertion of an Artisan lens for the treatment of high myopia. The Hartmann-Shack sensor was a useful tool for the objective assessment of the image optical quality of eyes with a phakic intraocular lens.