Objective: To evaluate the long-term refractive and visual outcomes in patients undergoing Artisan or Artiflex phakic intraocular lens (pIOL) implantation for high ametropia.

Methods: A retrospective cohort study. Myopic and hyperopic patients seeking refractive correction who could not undergo or could not have fully correction with corneal refractive surgery were submitted to pIOL implantation. Baseline characteristics and postoperative outcomes were reported for patients who completed the minimum follow-up of twelve months between January 1999 and December 2018. The report included refractive outcomes and spherical equivalent (SE) power, surgeries performed to achieve emmetropia, endothelium cell density and complications.

Results: The study evaluated 195 eyes, with a mean follow-up of 84.86 ± 56.19 months. The majority of patients underwent myopic correction (175/195, 89.74%). Fifty-six (56/175, 30%) and 6 (6/20, 30%) patients underwent corneal refractive surgery after pIOL (Bioptics) to correct any residual refractive errors in the myopic and hyperopic groups, respectively. The mean pre-operative SE was -13.06 ± 3.64 D in the myopic and +8.01 ± 2.55 D in the hyperopic group. A final SE of ± 2.0 diopters (D) was achieved in 91.4% and 95% of the myopic and hyperopic groups, respectively. Cataract was the most frequent complication, followed by glaucoma and uveitis. There was significant endothelial cell loss in the myopic patients (p<0.001), although no clinical corneal edema had developed by the time of the follow-up.

Conclusion: Phakic intraocular lenses are effective in refractive corrections and can be an invaluable option for patients meeting the inclusion criteria.

Phakic intraocular lens, Myopia, Hyperopia, Artisan, Artiflex