Jonker SMR, et al. - In this prospective case series involving 250 patients (460 eyes), mean age 41.1 years ± 10.7 [SD], researchers assessed the long-term refractive and visual, anterior chamber depth, and axial length (AL) changes and complications after rigid iris-fixated phakic intraocular lens (pIOL) implantation to treat myopia or astigmatism. The study sample consisted of individuals who had implantation of an Artisan myopic or toric iris-fixated pIOL as of January 1998. The mean myopization over 10 years was −0.79 diopters (D), with 52% of eyes within ± 1.0 D of target. Over 10 years, the mean increase in the logarithm of the minimum angle of resolution corrected distance visual acuity (CDVA) was 0.05. Findings suggested that 10 years after rigid iris-fixated pIOL implantation, the CDVA and uncorrected visual acuity significantly decreased as a result of significant myopization due to increased AL unrelated to the pIOL. Due to cataract formation, higher preoperative age and longer AL were risk factors for shorter survival.