Implantation of the Black Artisan Iris-Claw Intraocular Lens: A Case Series

Abstract

In this case series, we report the use of the black Artisan iris-claw intraocular lens (IOL) (Ophtec, The Netherlands) in 6 patients with various visually debilitating symptoms requesting occlusion of one eye. Between 2016 and 2019, 6 (5 female, 1 male) patients underwent implantation of the custom-made black Artisan iris-claw IOL after other management strategies had failed to relieve their symptoms. The black Artisan IOL is an opaque anterior chamber IOL that is fixated to the iris by enclavation. Data were obtained from the electronic patient records (Epic, Verona, WI, USA). All implantation surgeries were uneventful. In terms of outcomes, 4 patients (67%) were satisfied with the result. In 2 patients (33%), the dysphotopic symptoms were not resolved, and these patients opted for either an enucleation or an evisceration. In conclusion, a black Artisan IOL is a valuable and - if needed - reversible option in the management of patients suffering from monocular debilitating visual symptoms leading to disturbances of binocular vision. The clinical presentation leading to the implantation of a pupil-occluding IOL varies and patient satisfaction following implantation is variable. Careful preoperative evaluation of patient factors and expectations, and stepped-care management is recommended to minimize treatment failure. Pupil-occluding lens implantation is often the last step in the treatment of intractable visual complaints in eyes with complex ophthalmologic history, before evisceration or enucleation.

Keywords: Binocular visual dysfunction; Black Artisan intraocular lens; Intractable diplopia; Lens implantation; Pupil-occluding intraocular lens.

Fig. 1

a, b Case 3, 4 months postoperatively. The IOL is slightly decentered and does not cover the pupil superiorly, as shown in a. Cellular precipitates on the IOL surface are visible in b. c Case 4, 1 month postoperatively. d Case 5, 10 days postoperatively.