Refractive outcomes of Carlevale IOLs compared to Artisan iris-claw IOLs considering the type of incision

Purpose: To compare the refractive outcomes and the complications of implantation surgery by the Carlevale IOL to the Artisan iris-claw IOL. Methods: Retrospective comparative study of consecutive surgical cases between 2019 and 2021 in our tertiary centre in Paris, France. Results: We included 142 eyes in the Artisan group and 63 in the Carlevale group. Post-operative astigmatism at one month was 2.3 +/- 1.6 D in the Carlevale group, 3.3 +/- 2.5 D in the Artisan group with corneal incisions, and 1.8 +/- 1.4 D in the Artisan group with scleral incisions (p = 0.015). Surgery duration was higher (p = 0.007) with the Carlevale IOL (70.8 +/- 31.3 min) than with the Artisan IOL (58.3 +/- 23.2 min). The complication rates were similar at one month between the two groups (25.4% in Artisan, 27% in Carlevale). The mean follow-up was longer in the Artisan group (234.5 days vs. 77 days, p < 0.001). Conclusion: Artisan iris-claw IOL seems to induce higher astigmatism than Carlevale sutureless scleral-fixated IOL at one month when injected through a corneal incision, but not when injected through a scleral incision. Therefore cataract surgeons should avoid wide corneal incisions in implantation surgery whenever possible.