To evaluate the efficacy, safety, stability and complications of the foldable iris-fixated phakic intraocular lens (Artiflex®, Ophtec BV, Groningen, Netherlands) implantation for the correction of myopia with astigmatism.

The present study included 40 eyes of 20 patients who underwent Artiflex lens implantation, and 20 eyes of 10 patients who underwent Toric Artiflex lens implantation and were followed up for 1 year. We retrospectively examined visual acuity, refraction, any changes in astigmatism, efficacy, safety and corneal endothelial cell density. A correlation coefficient analysis of the factors that affected the changes was performed.

The mean preoperative refractive spherical equivalent was -9.18 ± 2.27 D and reached -0.45 ± 0.45 D at 1 year after surgery. Postoperatively, 99.9% of the eyes showed improved visual acuity of more than 0.8. In patients with Toric Artiflex lens implantation, the preoperative mean astigmatism was -2.67 ± 0.87 D, and at 1 year postoperatively -0.76 ± 0.40 D, showing a statistically significant decrease ( p < 0.001). The preoperative mean endothelial cell density was 2,850 ± 230 cells/mm² and decreased 1.3% on the final follow-up (2,812 ± 261 cells/mm²) but without statistical significance ( p = 0.456). Statistically significant correlation was not observed between endothelial cell loss and anterior chamber depth (r² = -0.146, p = 0.267).

Implantation of the iris-fixed intraocular lenses, Artiflex and Toric Artiflex, was safe and effective for correcting high myopia and astigmatism.