Artiplus: A New Path for Young Presbyopes
CAKE Magazine
The latest and greatest in cataract, refractive and anterior segment. Published by Media MICE.
by Diana Truong
At the private Artiplus Expert Panel event during ESCRS 2024 in Barcelona, Spain, a select group of refractive surgeons gathered to explore Ophtec’s latest innovation—Artiplus. The invitation-only event united leading voices in the field to discuss how this iris-fixated multifocal phakic intraocular lens (IOL) could transform presbyopia correction, continuing Ophtec’s legacy of advancing vision care.
Ophtec, a long-standing leader in the intraocular lens industry, is expanding its reach with Artiplus, building on its well-known Artiflex platform. Known for its expertise in phakic IOLs, Ophtec’s latest lens is designed to meet the growing demand for presbyopia and myopia correction, offering new advancements tailored to modern patient needs.
The Artiplus Expert Panel featured key figures from Ophtec (Groningen, Netherlands), including marketing manager Remko Bos , product and business development manager Tiago Guerreiro , and R&D manager Paolo Soleri . They were joined by prominent clinical experts such as Prof. Dr. José Luis Güell (Spain) and Dr. Julián Cezón (Spain), who shared insights from the Artiplus clinical trials. Surgeons Dr. Chan-Young Im (South Korea) and Prof. Dr. Ramin Khoramnia (Germany) contributed their perspectives, emphasizing the lens’s potential and performance.
A clear philosophy
At the heart of the Artiplus iris-fixated multifocal IOL lies a rich tradition of innovation, rooted in Ophtec’s journey through decades of IOL development. This journey began with the creation of the Worst claw iris-fixated lens by Prof. Dr. Jan Worst, Ophtec’s founder. Over time, it evolved into the Artisan, and later the Artiflex—a foldable version that offered more flexibility for surgical implantation.
Artiplus is the natural progression in this lineage, designed to address presbyopia in a growing demographic of patients. As Bos noted, “This is not only a new lens but a lens in a tradition.”? Ophtec’s philosophy of patient-centric design is evident in Artiplus, delivering seamless vision correction across distances without compromising stability or comfort.
Addressing a growing market
With the global population aging, the demand for vision correction solutions is rising. By 2050, it’s projected that around 52% of the world’s population will be myopic, with an estimated 80% to 90% of young adults in Asia already affected. Meanwhile, presbyopia now impacts 1.8 billion people globally.1,2,3
Artiplus serves a specific and growing population: adults between the ages of 40 and 60, too young for cataract surgery but grappling with presbyopia. “We call Artiplus the solution for young presbyopes,” noted Soleri.?
Many in this age group are typically still in the prime of their lives—professionally, socially, and physically active—and are looking for a solution that restores their vision without the need for glasses or contact lenses.?
Design and technology
Artiplus stands out in the crowded field of premium lenses by offering an innovative blend of advanced technology and patient-centered design, built on the trusted Artiflex platform with over 20 years of demonstrated safety and efficacy. Its design focuses on delivering “natural vision” across a full range of distances.
Unlike traditional multifocal lenses, which often rely on fixed, annular rings for near and far vision, the Artiplus employs a purely refractive optic with segments that smoothly transitions between distances. Soleri noted, “We translated this into the CTF technology, a multi-segmented, purely refractive optic with far/near zones.”?
This smooth focus adjustment also helps minimize common visual disturbances, such as glare and halos, which can be problematic with more traditional multifocal lenses. “We didn’t introduce any diffractive rings or aberration corrections to the lens because we wanted to preserve the patient’s natural vision,” Soleri explained. “We believe this is especially important in younger, healthier eyes.”?
Decentration tolerance is another key feature. Many multifocal lenses require perfect centration for optimal outcomes, but Artiplus is designed to perform well even when slightly decentered. “We didn’t want any abrupt changes in optical properties,” Soleri noted. The lens’s low add power of +2.5 diopters ensures strong intermediate vision while providing functional near vision without compromising performance.
Another major advantage is its iris-fixated design, which places the lens far from the natural lens, reducing the risk of cataract development in younger, myopic patients. “Anything that avoids lens surgery in young myopic patients is a major advantage,” emphasized Prof. Dr. Khoramnia.
Patient satisfaction
While clinical data is important, the true measure of Artiplus’s effectiveness comes from patients. In the ongoing clinical trial, 98% of participants reported being “quite to very satisfied” with their uncorrected vision post-operatively.
Satisfaction rates were highest for distance and intermediate vision, with 100% of patients expressing satisfaction, while 90% were pleased with their near vision.
One early adopter, a professional rugby player from Spain, epitomizes the lens’s success. “He’s a very happy patient,” noted Dr. Cezón, who added that the athlete continues to enjoy excellent vision nearly three years post-implantation.
Built for the future
The safety of Artiplus is supported by the strong track record of the Artiflex platform, which has demonstrated minimal loss of endothelial cells over time. "There are reports about the loss of only 1% of endothelial cells per year," shared Prof. Dr. Khoramnia from Heidelberg University, underlining that proper patient selection is key to maintaining this level of safety.
While all phakic IOLs carry some risk to the endothelium, the Artiplus’ iris-fixated design places it further away from the natural lens, minimizing the potential for complications. Prof. Dr. Khoramnia noted the importance of this design, especially in younger patients where posterior chamber phakic lenses can lead to an increased risk of early cataract formation.
Another option, clear lens exchange (CLE), though effective for presbyopia and other refractive errors, involves removing the natural lens and can heighten the risk of retinal detachment, especially in highly myopic individuals. Artiplus offers a safer, long-term alternative by preserving the natural lens and providing clear vision correction without the added risks of CLE. This makes Aritplus an appealing option for younger patients seeking early presbyopia correction, offering both stability and a lower complication profile.
From presbyopia to cataract
Artiplus is specifically designed to bridge the gap between presbyopia correction and the eventual need for cataract surgery, allowing patients to enjoy a unique balance of clarity and long-term flexibility. Because Artiplus preserves the natural lens, unlike other solutions, it leaves future cataract surgery options open—an advantage over laser procedures that might limit these choices as patients age.?
"If we mount it in a 45-year-old and 10 years later the patient develops a pathology, it’s quite easy to reverse whenever necessary," Prof. Dr. Khoramnia explained. This means patients can confidently address their presbyopia now, knowing the lens can be removed or replaced if needed, such as when cataract surgery becomes necessary.
As these patients eventually transition to cataract surgery, the familiarity with the procedure and continuity of care make Artiplus an attractive option for both patients and surgeons alike. Through this approach, Ophtec has crafted a lens that not only meets the demands of today’s presbyopic patients but also anticipates their future needs, offering clear vision now, without compromise, and into the years ahead.
Editor’s Note: Reporting for this story took place during the 42nd Congress of the European Society of Cataract and Refractive Surgery (ESCRS 2024), held from 6-10 September in Barcelona, Spain.
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