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Mariana C. Navarro, Regina Velasco, Alejandro Babayan, Oscar Baca, Oscar Fernandez; Comparison Between Phakic Intraocular Lens: Acrysof Cachet Versus Artisan. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5777.
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To determine the safety and effectiveness of two different kinds of phakic intraocular lens (IOL) AcrySof Cachet and Artisan for the correction for moderate to high myopia .
Observational, retrospective, longitudinal, case series, from April 2007 to November 2010. We evaluated patients with refractive stability, who were not elegible for excimer laser surgery, anterior chamber (AC) >2.6mm and endothelial cell density >2000/mm², without any ocular pathology, who underwent phakic IOL implantation with at least three months of follow up. Patients were divided in two groups: 1) Patients with AcrySof phakic angle-supported IOL: Cachet. 2) Patients with iris - supported phakic IOL: Artisan. We evaluated Visual acuity (AV) logMAR, best corrected visual acuity (BCVA) logMAR, Spherical equivalent (SE), intraocular pressure (IOP) with Goldmann tonometer, endothelial density cell count (specular microscopy). Before surgery and at the first week, month, 3 months and in whom had already met 6 months or a year after surgery.
We evaluated 13 eyes, 7 in group one and 6 eyes in group two: 77% were female with a mean age of 30 years old (±9), SE -11D (±2.6). VA of 1.78 logMAR and BCVA of 0.17 logMAR-. AC depth of 3.4mm (±0.28) and average endothelial cell density of 2827 cells/mm². The AcrySof Cachet (group 1) had a mean VA of 0.09 logMAR (20/25) and 43% with VA of 0 logMAR (20/20), none had VA less than 0.17 (20/30). They had a mean IOP of 16.5mmHg (10 - 20mmhg) and only 14%(one patient) had a loss of more than 1000/mm² endothelial cells in the first 3 months. The Artisan (group 2) none had a VA better than 0.09 logMAR (20/25) and 33% worse than 0.30 logMAR (20/40). Average IOP of 21mmhg (12 - 40mmhg). The use of hypotensive agents was needed in 33% and 50% needed 2 or more drugs. In 16% had to be proposed trabeculoplasty. Pupilar ovalization was reported in 33%, 16% had an endothelial density loss of >1000/mm² and in 16% the IOL was extracted due a loss of 74% of endothelial cell density. At 3 months both groups had an average endothelial cell density loss of 8% and Artisan at one year had 21%. As it was expected the AV, BCVA and SE was statistically significant better after surgery in both groups. P < 0.000
The effectiveness with both IOL's is similar, that AcrySof phakic angle-supported IOL Cachet is safer in a short term postoperative period.
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