Review Article

Surgical Management of Paediatric Aphakia in the Absence of Sufficient Capsular Support

Table 2

The most important studies of Artisan IOL in paediatric aphakic patients.

StudyDesignNumber of patients (eyes)Key results

Lifshitz et al. (2004)Retrospective Artisan IOL for idiopathic subluxated lenses3 (4)(1) Postoperative BCVA 6/12 or better in 3 cases that could be recorded
(2) VA improved by 2 or more Snellen lines in all eyes
(3) Complications: none

Odenthal et al. (2006)Retrospective ECL evaluation after Artisan IOL for traumatic and congenital cataract10 (10)(1) ECL: 41% in the traumatic cataract group
(2) ECL related to the original corneal scar length of the trauma
(3) No statistical difference in ECC between operated and unoperated eye in the congenital cataract group

Sminia et al. (2007)Retrospective Artisan IOL for aphakia after trauma5 (5)(1) Postoperative BCVA 20/40 or better in 4 eyes
(2) Mean ECL: 40%
(3) Complications: retinal detachment 19 months after primary injury in one eye

Hirashima et al. (2010)Randomized controlled trial anterior vs. posterior chamber iris-claw IOL lens subluxation in Marfan16 (31)(1) Postoperative BCVA did not differ significantly between groups
(2) Complications: IOL dislocation (n = 3) in the PCIOL group, retinal detachment (n = 3) in both groups
(3) Mean postoperative foveal thickness decreased in 54.16% of the patients

Sminia et al. (2011)Retrospective ECL evaluation after Artisan IOL for traumatic and congenital cataract10 (20)Postoperative mean ECC comparable to the mean normal ECC for this age group reported in the literature

Sminia et al. (2012)Retrospective Artisan IOL for ectopia lentis in Marfan2 (4)Good postoperative visual outcome, no serious IOL-related complications, and ECC within the expected range for normal eyes

Cleary et al. (2012)Retrospective Artisan iris-claw IOL for ectopia lentis5 (8)(1) Postoperative mean VA: 0.04 ± 0.09 logMAR
(2) Mean postoperative ECL: 14.2%
(3) Complications: none

Siddiqui et al. (2013) 23316948Prospective evaluation of visual outcomes and ECC after Artisan IOL for lens subluxation11 (18)(1) Mean postoperative BCVA: 0.26 ± 0.13 logMAR
(2) Mean postoperative ECL: 17.1%

Tychsen and Faron (2013)Prospective outcomes of Artisan IOL for aphakia17 (28)(1) Postoperatively, BCVA improved an average 2 Snellen lines (0.18 logMAR)
(2) Complications: pupillary block (n = 4) and de-enclavation (n = 1)

Gawdat et al. (2015)Prospective outcomes of Artisan IOL for aphakia18 (25)(1) Postoperative BCVA for traumatic aphakia and lens subluxation improved to 0.38 ± 0.15 logMAR and 0.3 ± 0.2 logMAR , respectively
(2) One year postoperative significant decrease of ECC (2892.64 ± 441.79 cells/mm2)
(3) Complications: traumatic dislocation (n = 2), pupillary block (n = 1)

Manning et al. (2016)Retrospective outcomes after Artisan IOL for ectopia lentis in Marfan8 (16)(1) Mean postoperative BCVA: 0.12 ± 0.19 logMAR
(2) Mean postoperative ECL: 15.4%
(3) Complications: pupillary block (n = 1) and de-enclavation (n = 1)

Kavitha et al. (2016)Retrospective outcomes of Artisan IOL vs. PCIOL for traumatic cataract50 (50)(1) BCVA improvement in both groups with no significant difference in BCVA logMAR between them
(2) Complications in the Artisan IOL group: secondary glaucoma (n = 1), IOL de-enclavation (n = 1), and cystoid macular edema (n = 1)

Catala-Mora et al. (2017)Prospective outcomes of Artisan IOL for ectopia lentis12 (21)(1) Mean BCVA improved from 0.91 ± 0.29 logMAR to 0.18 ± 0.23 logMAR at final follow-up
(2) Postoperative ECL: 5.04% ± 9.58% with an annual ECL rate of 3.16% ± 4.46%
(3) Complications: traumatic IOL dislocation and retinal detachment (n = 1), cystoid macular oedema (n = 1)

IOL: intraocular lens, BCVA: best corrected visual acuity, VA: visual acuity, ECL: endothelial cell loss, and ECC: endothelial cell count.