Study of pupillary motility after implantation of an iris claw lens (Artisan®) in a phakic population with severe myopia

Purpose: To assess the effect of the Artisan (R) lens on pupillary motility in a highly phakic myopic population. Patients and methods: Eleven patients (21 eyes) were enrolled in a nonrandomized prospective study between September 2002 and August 2003, with a 6- to 11-month follow-up. A portable Colvard pupillometer was used to measure pupil diameters before and after surgery under two different light conditions: one with scotopic surroundings with absolute darkness in the examination room and the other maximal simulated photopic surroundings, caused by the instillation of a pilocarpine 2% drug until a nonreactive myosis could be observed. Under such light conditions, both the horizontal and vertical pupil motion ranges were measured. Measures were then sorted into five temporal segments in order to have enough samples per temporal segment for a cohesive data analysis. Mean values and confidence intervals were then derived per temporal segment according to Student's law. Constraints on the pupil motion range were identified. Results: After implantation of an Artisan' lens, the pupil motion range was limited to both horizontal and vertical axes. For the horizontal axis, the motion range was 4.3 +/- 0.2mm (P=0.1) before claw implantation and was 2.7 +/- 0.5mm (p=0.1) 9 months after claw implantation. For the vertical axis, the motion range was 4.46 +/- 0.28mm before claw implantation and 3.08 +/- 0.89mm 9 months after claw implantation. Conclusions: The Artisan' lens durably restrains the pupil in its motion range and introduces a noticeable oval deformation under extreme light condition variations. This side effect is, however, not visible under regular conditions but only in maximal photopic surroundings.