Assessment of a single-piece hydrophilic acrylic IOL for piggyback sulcus fixation in pseudophakic cadaver eyes

Abstract

To evaluate a single-piece hydrophilic acrylic intraocular lens (IOL) designed for sulcus fixation in a piggyback configuration in postmortem pseudophakic human eyes. John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Experimental study. Pseudophakic human cadaver eyes were imaged by high-frequency ultrasound (Artemis) to assess the overall position of the primary IOL and the sulcus diameter. The piggyback IOL (Sulcoflex) was then injected into the ciliary sulcus of these eyes. After fixation in formalin, they were reevaluated by high-frequency ultrasound for assessment of IOL fixation, fit, centration, tilt, and clearance from the primary IOL and intraocular structures and analyzed after sectioning. Data could be obtained from 11 eyes, all in which the primary IOL was located in the capsular bag. Different foldable IOLs and different degrees of Soemmerring ring formation were represented. The piggyback IOL could be injected and positioned in the ciliary sulcus and had overall appropriate centration and minimum or no tilt. Clearance between the 2 IOLs ranged from 232 to 779 μm, mostly depending on the thickness of the primary IOL. Direct assessment of the sulcus-fixated haptics showed no disturbances to the ciliary processes. The new IOL has large optic and overall diameters, smooth and undulating haptics, and a convex-concave optic profile. Results show that these characteristics minimize the possibility of interaction with the primary IOL and uveal tissues, decreasing the likelihood of optical aberrations and pigmentary dispersion.