Artisan lens implantation to correct aphakia after vitrectomy for retained nuclear lens fragments

Purpose: To report the results of pars plana vitrectomy (PPV) for retained lens fragments with implantation of an Artisan intraocular lens (IOL) (Ophtec) to correct aphakia. Setting: University-based referral center. Methods: In this retrospective case-controlled study, patients who had had a PPV to remove dislocated lens fragments and implantation of an Artisan IOL for pseudophakic correction during initial cataract surgery or PPV were reviewed. Results: Thirteen patients were identified. The preoperative visual acuity was better than 20/200 in 5 patients and the intraocular pressure (IOP) was higher than 21 mm Hg in 8 patients; 3 patients had normal corneas. In 4 patients, an Artisan IOL was implanted during cataract surgery. Postoperative complications included recurrent erosion (1 eye), premacular fibrosis (2 eyes), and a retinal tear (1 eye). Elevation of the IOP occurred in 2 patients and was controllable with medication. Pupillary block developed in 1 patient and persistent cystoid macular edema in another. All but 2 patients gained more than 2 lines of visual acuity postoperatively, and all corneas remained clear during the follow-up (mean 28.9 months; range 2.5 to 69.0 months). Conclusions: After the removal of dislocated lens fragments with a PPV, Artisan IOL implantation in aphakic patients without capsule support led to few complications and good visual acuity. Placement of an Artisan IOL requires fewer manipulations than transscleral suture fixation of a posterior chamber IOL. (C) 2004 ASCRS and ESCRS.