Visual outcomes and safety profile of retropupillary iris-claw Artisan intraocular lens implants.

Objective: The Artisan is an iris-claw intraocular lens (IOL) that can be used to correct aphakia in eyes with insufficient capsular support. This study aims to evaluate long-term visual outcomes and complications following retropupillary implantation of the Artisan IOL at a Canadian centre.

Design: Retrospective chart review.

Participants: Patients who underwent implantation of an Artisan IOL at a tertiary Canadian center between January 2013 and December 2021.

Methods: Retrospective chart review was performed, and clinical outcomes at postoperative follow-up visits were summarized. Outcomes included postoperative best corrected and uncorrected distance visual acuity (BCDVA and UCDVA), intraocular pressure (IOP), as well as intraoperative and postoperative complications.

Results: Seventy-three eyes of 67 patients were evaluated. Mean follow-up duration was 11 months (range: 1-63 months). Common indications for Artisan implantation were IOL dislocation (n = 50; 68.5%) and aphakia (n = 23; 31.5%). Causes for IOL dislocation included idiopathic zonular weakness (n = 25; 34.2%), pseudo-exfoliation (n = 14; 19.2%), surgical complications (n = 6; 8.2%), trauma (n = 3; 4.1%), and Marfan syndrome (n = 2; 2.7%). Causes for aphakia included complicated cataract surgery (n = 20; 27.4%), ocular trauma (n = 2; 2.7%), and post-vitrectomy and lensectomy (n = 1; 1.4%). Average BCDVA (logMAR) was 0.62 ± 0.56 at preop, 0.46 ± 0.55 at 3 months postop, and 0.43 ± 0.55 at 9-12 months (p < 0.0001). Average UCDVA (logMAR) was 1.19 ± 0.68 at preop, 0.65 ± 0.60 at 3 months postop, and 0.42 ± 0.46 at 9-12 months (p < 0.0001). IOP did not differ significantly in follow-up. Pupil ovalization (n = 11, 15.1%) was the most common complication.

Conclusions: Outcomes demonstrated favourable efficacy and safety of retropupillary Artisan IOL as an option for providing adequate visual rehabilitation for patients without sufficient capsular support.