J Korean Ophthalmol Soc.  2012 Sep;53(9):1254-1259. 10.3341/jkos.2012.53.9.1254.

Effects of Prone Positioning on Critical Distance in Iris-Claw Phakic Intraocular Lens-Implanted Eyes

• Kim WK
• Kim HS
• Cho EY
• Kim JK
• Yang H

• KMID: 2216077
• DOI: http://doi.org/10.3341/jkos.2012.53.9.1254

Abstract

PURPOSE
To evaluate the effects of prone positioning on the critical distance (CD) in Artiflex (Ophtec BV) foldable anterior iris-claw phakic intraocular lens (pIOL)-implanted eyes.
METHODS
Twenty patients with 40 Artiflex-implanted eyes were prospectively enrolled in the present study. The nasal and temporal critical distances (CD) were measured with Visante anterior segment optical coherence tomography (OCT, Carl Zeiss, Dublin, CA) in both the sitting and prone positions.
RESULTS
The mean nasal CD was 1.52 +/- 0.15 mm in the sitting position and 1.49 +/- 0.13 mm in the prone position (p = 0.01). The mean temporal CD was 1.63 +/- 0.17 mm in the sitting position and 1.63 +/- 0.16 mm in the prone position (p = 0.67). In a multiple regression analysis, the changes in nasal CD were positively correlated with anterior chamber volume (r = 0.27; p = 0.01) and negatively correlated with pupil size (r = -0.23; p < 0.01).
CONCLUSIONS
Prone positioning can induce a decrease in the nasal CD in Artiflex-implanted patients, especially in subjects with small pupils and large anterior chamber volumes.

Keyword

Artiflex; Critical distance; Iris claw; Phakic intraocular lens; Prone position

MeSH Terms

Anterior Chamber
Eye
Humans
Miosis
Phakic Intraocular Lenses
Prone Position
Prospective Studies
Pupil
Tomography, Optical Coherence

Figure

• 

  Figure 1 Box plot showing the change of critical distance nasal (A) and temporal (B) between sitting and prone position.

Reference

1. Maloney RK, Nguyen LH, John ME. Artisan phakic intraocular lens for myopia:short-term results of a prospective, multicenter study. Ophthalmology. 2002. 109:1631–1641.

2. Tahzib NG, Nuijts RM, Wu WY, Budo CJ. Long-term study of Artisan phakic intraocular lens implantation for the correction of moderate to high myopia: ten-year follow-up results. Ophthalmology. 2007. 114:1133–1142.

3. Benedetti S, Casamenti V, Marcaccio L, et al. Correction of myopia of 7 to 24 diopters with the Artisan phakic intraocular lens: two-year follow-up. J Refract Surg. 2005. 21:116–126.

4. Yamaguchi T, Negishi K, Kato N, et al. Factors affecting contrast sensitivity with the Artisan phakic intraocular lens for high myopia. J Refract Surg. 2009. 25:25–32.

5. Qasem Q, Kirwan C, O'Keefe M. 5-year prospective follow-up of Artisan phakic intraocular lenses for the correction of myopia, hyperopia and astigmatism. Ophthalmologica. 2010. 224:283–290.

6. Arntz A, Arango M, Durán JA. [Iris-claw phakic intraocular lens for high myopia correction. Visual and refractive results]. Arch Soc Esp Oftalmol. 2003. 78:243–250.

7. Asano-Kato N, Toda I, Hori-Komai Y, et al. Experience with the Artisan phakic intraocular lens in Asian eyes. J Cataract Refract Surg. 2005. 31:910–915.

8. Güell JL, Morral M, Gris O, et al. Five-year follow-up of 399 phakic Artisan-Verisyse implantation for myopia, hyperopia, and/or astigmatism. Ophthalmology. 2008. 115:1002–1012.

9. Peris-Martínez C, Artigas JM, Sánchez-Cortina I, et al. Influence of optic quality on contrast sensitivity and visual acuity in eyes with a rigid or flexible phakic intraocular lens. J Cataract Refract Surg. 2009. 35:1911–1917.

10. Artigas JM, Peris C, Felipe A, et al. Modulation transfer function: rigid versus foldable phakic intraocular lenses. J Cataract Refract Surg. 2009. 35:747–752.

11. Tahzib NG, MacRae SM, Yoon G, et al. Higher-order aberrations after implantation of iris-fixated rigid or foldable phakic intraocular lenses. J Cataract Refract Surg. 2008. 34:1913–1920.

12. Dick HB, Budo C, Malecaze F, et al. Foldable Artiflex phakic intraocular lens for the correction of myopia: two-year follow-up results of a prospective European multicenter study. Ophthalmology. 2009. 116:671–677.

13. Tehrani M, Dick HB. Changes in higher-order aberrations after implantation of a foldable iris-claw lens in myopic phakic eyes. J Cataract Refract Surg. 2006. 32:250–254.

14. Nishida T, Saika S. Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea and sclera: anatomy and physiology. Cornea. 2011. v. 1:3rd ed. St. Louis: Mosby/Elsevier;15–16.

15. Edelhauser HF. The resiliency of the corneal endothelium to refractive and intraocular surgery. Cornea. 2000. 19:263–273.

16. Armitage WJ, Dick AD, Bourne WM. Predicting endothelial cell loss and long-term corneal graft survival. Invest Ophthalmol Vis Sci. 2003. 44:3326–3331.

17. Bourne WM, Nelson LR, Hodge DO. Central corneal endothelial cell changes over a ten-year period. Invest Ophthalmol Vis Sci. 1997. 38:779–782.

18. Yee RW, Matsuda M, Schultz RO, Edelhauser HF. Changes in the normal corneal endothelial cellular pattern as a function of age. Curr Eye Res. 1985. 4:671–678.

19. Møller-Pedersen T, Møller HJ. Viability of human corneal keratocytes during organ culture. Acta Ophthalmol Scand. 1996. 74:449–455.

20. Menezo JL, Cisneros AL, Rodriguez-Salvador V. Endothelial study of iris-claw phakic lens: four year follow-up. J Cataract Refract Surg. 1998. 24:1039–1049.

21. Pérez-Santonja JJ, Bueno JL, Zato MA. Surgical correction of high myopia in phakic eyes with Worst-Fechner myopia intraocular lenses. J Refract Surg. 1997. 13:268–281.

22. Silva RA, Jain A, Manche EE. Prospective long-term evaluation of the efficacy, safety, and stability of the phakic intraocular lens for high myopia. Arch Ophthalmol. 2008. 126:775–781.

23. Kim M, Kim JK, Lee HK. Corneal endothelial decompensation after iris-claw phakic intraocular lens implantation. J Cataract Refract Surg. 2008. 34:517–519.

24. van Eijden R, de Vries NE, Cruysberg LP, et al. Case of late-onset corneal decompensation after iris-fixated phakic intraocular lens implantation. J Cataract Refract Surg. 2009. 35:774–777.

25. Tehrani M, Dick HB. Endothelial cell loss after toric iris-fixated phakic intraocular lens implantation: three-year follow-up. J Refract Surg. 2007. 23:172–177.

26. Wang KJ, Zhu SQ. Spontaneous dislocation of a Verisyse phakic intraocular lens with severe corneal endothelial cell loss. Eur J Ophthalmol. 2010. 20:601–603.

27. Stulting RD, John ME, Maloney RK, et al. Three-year results of Artisan/Verisyse phakic intraocular lens implantation. Results of the United States Food And Drug Administration clinical trial. Ophthalmology. 2008. 115:464–472.

28. Pop M, Payette Y. Initial results of endothelial cell counts after Artisan lens for phakic eyes: an evaluation of the United States Food and Drug Administration Ophtec Study. Ophthalmology. 2004. 111:309–317.

29. Landesz M, van Rij G, Luyten G. Iris-claw phakic intraocular lens for high myopia. J Refract Surg. 2001. 17:634–640.

30. Kim SE, Hong SM, Lee HK. Long-term change in corneal endothelium after iris-fixed phakic intraocular lens insertion. J Korean Ophthalmol Soc. 2009. 50:677–683.

31. Choi WS, Lee HY, Seo SG, Her J. Clinical outcomes of implantable contact lens and iris-fixed intraocular lens for correction of myopia. J Korean Ophthalmol Soc. 2008. 49:1406–1414.

32. Sekundo W, Bissmann W, Tietjen A. Behaviour of the phakic iris-claw intraocular lens (Artisan/Verisyse) during accommodation: an optical coherence biometry study. Eur J Ophthalmol. 2007. 17:904–908.