Changes in the accommodation-convergence relationship after the Artisan phakic intraocular lens implantation for myopic patients.

Various types of refractive surgery are becoming increasingly popular to those seeking an alternative to wearing glasses [1]. Besides excimer laser photorefractive keratectomy and laser in-situ keratomileusis (LASIK), implanting an intraocular lens in a phakic eye has become one of the most attractive surgical options for myopia correction [2]. For severe myopia patients, the excimer laser technology may be considered unsuitable because of anatomical structure incompatibility resulting in correction instability, haze, and corneal ectasia [2]. However, phakic intraocular lens (PIOL) implantation has opened an alternative way to correct the myopia without structural complications related to the excimer laser. The implantation of Artisan PIOL is considered a stable, safe method to correct moderate and severe myopia if strict inclusion criteria are applied [3]. The implantation of Artisan PIOL produced a state of near emmetropia in a patient with previous myopia, increasing the amount of accommodation required for near vision. In addition, in the absence of the prismatic effect of concave glasses, the convergence required for near fusion is also altered in myopia [4]. Due to these conditions, patients with the Artisan PIOL implantation might experience asthenopic symptoms such as double vision and blurring immediately after surgery. However, little has been described regarding the change in the accommodation-convergence relationship after Artisan PIOL implantation. This study was designed to evaluate accommodation-convergence related parameters such as accommodative convergence per unit of accommodation (AC/A) ratio, convergence amplitude, and near point of convergence (NPC) change following the Artisan PIOL implantation.