Hydrophobic Acrylic Intraocular Lens Research Articles

A novel 3D high resolution imaging method using correlative X-Ray and electron microscopy to study Nd:YAG laser induced defects in intraocular lenses.

Cataract extraction is the most frequently performed ophthalmological procedure worldwide. Posterior capsule opacification (PCO) remains the most common consequence after cataract surgery and can lead to deterioration of the visual performance with cloudy, blurred vision and halo, glare effects. Nd:YAG laser capsulotomy is the gold standard treatment and a very effective, safe and fast procedure in removing the cloudy posterior capsule. Damaging the intraocular lens during the treatment may occur due to wrong focus of the laser beam. These YAG-pits may lead to a permanent impairment of the visual quality. In an experimental study, we intentionally induced YAG pits in hydrophilic and hydrophobic acrylic intraocular lenses (IOLs) using a photodisruption laser with 2.6mJ. This experimental study established a novel 3D imaging method using correlative X-Ray and scanning electron microscopy to characterize these damages. By integrating the information obtained from both X-ray microscopy and SEM, a comprehensive picture of the materials structure and performance could be established. It could be revealed that although the exact same energies were used to all samples, the observed defects in the tested lenses showed severe differences in shape and depth. While YAG pits in hydrophilic samples range from 100 to 180 µm depth with a round shape tip, very sharp tipped defects up to 250 µm in depth were found in hydrophobic samples. In all samples, particles/fragments of the IOL material were found on the surface that were blasted out as a result of the laser shelling. Defects in hydrophilic and hydrophobic acrylic materials differ. Material particles can detach from the IOL and were found on the surface of the samples. The results of the laboratory study illustrate the importance of a precise and careful approach to Nd:YAG capsulotomy in order to avoid permanent damage to the IOL. The use of an appropriate contact glass and posterior offset setting to increase safety should be carried out routinely.

Out glides the lens, up goes the pressure: multicenter analysis of intraocular pressure after preloaded hydrophobic acrylic monofocal intraocular lens insertion.

Out glides the lens, up goes the pressure: multicenter analysis of intraocular pressure after preloaded hydrophobic acrylic monofocal intraocular lens insertion.

Implantation of Hydrophobic Acrylic Toric Intraocular Lens with High-Water Contents Using Swept-Source Optical Coherence Tomography Biometer Integrated with a Surgical Guiding System.

To evaluate postoperative outcomes after implantation of toric intraocular lenses (IOLs) made of high-water-content hydrophobic acrylic material in Japanese patients using a swept-source optical coherence tomography (SS-OCT) biometer integrated with a surgical guiding system. In this prospective observational study, toric IOL models CNW0T3 to CNW0T9 (Alcon) were implanted in 33 eyes of 33 patients and followed-up for one month. Powers and toric models were determined using an SS-OCT biometer ARGOS® Ver 1.5 (Alcon), and the IOLs were aligned using surgical guidance. Differences between planned and actual axis positions at the end of the surgery (misalignment) and rotations from the end of surgery to one month postoperatively were measured. Additionally, postoperative uncorrected visual acuity, refraction, and residual astigmatism were evaluated. Mean and median misalignments were 2.3° (standard deviation [SD]: 1.6, 95% confidence interval [CI]: 1.7-2.9) and 2°, and those of postoperative rotation were 2.4° (SD: 2.6, 95% CI: 1.5-3.4) and 2°, respectively. Mean postoperative refraction was 0.06 D (SD: 0.62). Prediction errors within ±0.5 and ±1.0 D were 69.7% and 93.9%, respectively. Mean residual astigmatisms were 0.19 D (SD: 0.41), and mean uncorrected visual acuity was 0.00 logMAR (SD: 0.11), and 64% of the eyes scored 20/20 or better. Implantation of high-water-content hydrophobic acrylic toric IOLs using SS-OCT biometry integrated with a surgical guiding system effectively corrected corneal astigmatism with accurate IOL alignment in Japanese patients.

Comparison of Clinical Outcomes of Implantation of Foldable Hydrophobic Acrylic Intraocular Lens With and Without Heparin Surface Modification in Indian Diabetic Patients.

Background This study aimed to compare the clinical outcomes of a heparin surface-modified (HSM) hydrophobic acrylic foldable intraocular lens (IOL) (CT LUCIA 601PY) and non-heparin-modified hydrophobic acrylic foldable IOL (AcrySof IQ SN60WF) in diabetic patients undergoingphacoemulsification. Methodology Thisrandomized, single-surgeon, double-masked controlled trial was conducted at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. In this randomized controlled trial, 100 eyes of 100 diabetic patients with or without mild-to-moderate diabetic retinopathy were enrolled (HSM IOL, n = 50; non-HSM IOL, n = 50). Outcome measures were aqueous flare, visual acuity, and anterior chamber depth (ACD). These were measured preoperatively as well as one day, one week, one month, three months, six months, and one year postoperatively. Results The HSM IOL group had significantly lower anterior chamber aqueous flare values (photon count/ms) than the non-HSM IOL group on postoperative day one (9.97 ± 5.2 vs. 17.56 ± 11.3, p < 0.001), postoperative week one (11.47 ± 7.78 vs. 17.06 ± 9.4, p = 0.02), and postoperative month three (7.7 ± 4.1 vs. 12.5 ± 5.6, p = 0.004) of phacoemulsification. The corrected distance visual acuity (CDVA) was significantly better in the HSM IOL group on postoperative day one (uncorrected distance visual acuity: p = 0.022; CDVA; p = 0.005), but there was no significant difference at any other follow-ups. ACD was significantly longer in the HSM IOL group at all follow-ups. Conclusions Theimplantation of HSM IOL resulted in significantly lower inflammatory reactions in the early postoperative period in diabetics.

Aspheric hydrophobic acrylic intraocular lens outcomes in patients with additional ocular pathology

Objectives: The objective of the study was to examine the real-world visual performance, refractive outcomes, and glistening occurrence of a hydrophobic acrylic aspheric monofocal intraocular lens (IOL) in patients with ocular comorbidities. Materials and Methods: All cases of cataract surgery with the implantation of a hydrophobic acrylic aspheric monofocal IOL in a single centre between September 2020 and March 2022 were reviewed in a retrospective cohort study. Refraction (autorefract), visual acuity, peri- and post-operative complications, and the presence of posterior capsular opacification (PCO) and glistenings were recorded. Due to facility and surgeon preference, this lens was utilised predominantly for younger patients with additional ocular pathology. Results: Data regarding 15 patients (21 eyes) were collected. The mean age was 57.3 years (Range: 37–70). Eleven patients (73%) had ocular pathology in addition to cataracts. One patient was excluded due to a lack of follow-up. Post-operative refraction was available for 13 eyes (61%). The median follow-up time was five months. Corrected distance visual acuity (logarithm of the minimum angle of resolution) improved from 0.52 ± 0.54 to 0.17 ± 0.21 (mean ± standard deviation; P = 0.01); 95% confidence interval 0.08–0.26). 77% of eyes were within 0.5 D of the refractive target, and 92% were within 0.7 D. Six patients (30%) had documented PCO, with two requiring YAG capsulotomy. No patients had IOL glistenings. Conclusion: The hydrophobic aspheric monofocal IOL performs well for young patients with ocular pathology in addition to cataracts. Further, long-term follow-up will help to support its use for patients who require greater than standard longevity from an IOL.

Rotational stability of a new hydrophobic acrylic intraocular lens platform.

To evaluate rotational stability for ease of rotation of a new intraocular lens (IOL) platform with 4 haptics in an ex vivo model and compare it with a control single-piece lens with 2 open loops. Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. Experimental study. 10 human cadaver eyes were prepared as per the Miyake-Apple technique. After injection of the test or control lens, clockwise and counterclockwise rotations were attempted with a hook, with and without an ophthalmic viscosurgical device in place. Ease of rotation was scored as (1) very easy, (2) easy, (3) difficult, and (4) very difficult. Rotation of the entire eye containing test or control IOL was also performed with a multipurpose rotator (2 minutes; 220 revolutions per minute) to evaluate its effect on IOL alignment. There were statistically significant differences regarding ease of rotation between test and control lenses in all 4 scenarios, with rotation being more difficult with the test lens ( P < .05, Wilcoxon signed-rank test). No change in the alignment of test or control lenses was observed after eye rotation with the multipurpose rotator. The new IOL platform showed greater rotational stability than the control lens in this model, owing to design features such as 4 small arcs of contact between the haptics and the bag equator, a bulge at the distal end of each haptic, and arcuate haptics with curvatures oriented toward each other.

Rotational stability and capsular bag performance of a hydrophobic acrylic open-loop single-piece intraocular lens.

To evaluate the rotational stability and capsular bag performance of a blue light-absorbing hydrophobic acrylic open-loop single-piece intraocular lens (IOL) with a blast-finished anchor wing haptic design during the first 6 postoperative months. In this prospective clinical study, patients with age-related cataract and potential postoperative corrected distance visual acuity (CDVA) of 0.2 logMAR or better were included. The patients received a non-toric hydrophobic acrylic single-piece IOL with an axis mark (YST0.00; Nidek Co. Ltd, Japan). Surgeries were video-taped. Retroillumination images were acquired 1 h, 1 week and 6 months postoperatively. Rotational stability was assessed by precise image overlay. At 6 months, Purkinje meter measurements were performed to evaluate tilt and decentration. In total, 100 eyes of 77 patients were included in the analysis. Mean absolute rotation was 2.1 ± 1.7° (median 1.7, range: 0-7.9) at 6 months (1 h - 6 months postoperatively). IOL rotation was ≤3° and ≤6° in 74 (74%) and 98 (98%) eyes, respectively. Mean absolute IOL rotation from the end of surgery to 6 months was 2.5 ± 2.2° (median 2.3, range: 0-15.6; n = 78). Mean tilt (pupillary axis) and decentration were 4.1 ± 1.9° (median 4.0, range: 0.5-8.2) and 0.35 ± 0.17 mm (median 0.32, range: 0.06-0.91) respectively (n = 84). Postoperatively, 98 (98%) eyes achieved a CDVA of 0.2 logMAR or better, 95 (95%) of ≤0.1 and 81 (81%) of ≤0.0. This hydrophobic acrylic single-piece IOL showed an excellent rotational stability and capsular bag position with low tilt and decentration values.

Late spontaneous posterior capsule rupture with single-piece hydrophobic acrylic intraocular lens dislocation

In this study, we described and discussed the late onset spontaneous posterior capsule rupture with intraocular lens (IOL) dislocation years after uncomplicated cataract surgery and implantation of hydrophobic acrylic IOLs. Eight patients presented with spontaneous posterior capsule rupture and IOL dislocation 5–20 years after uncomplicated phacoemulsification and IOL (AcrySof, Alcon, US) implantation. None of the patients had undergone posterior capsulotomy in the past. Four of the patients admitted habitual eye rubbing. An intact and well-centered continuous curvilinear capsulotomy edge was observed in all cases. IOLs were dislocated or displaced behind the anterior capsulotomy with a significant decrease in vision. A large rupture with a curled edge of the broken posterior capsule was visible. Dislocated IOLs were removed, and a three-piece IOL was inserted in the sulcus in six cases and suture fixated to the sclera in two cases. Improved vision was achieved in all cases. Although the mechanism underlying this late complication is unclear, habitual eye rubbing or IOL design may play a role. Further investigation is needed to prevent this complication in the future.

Новые отечественные интраокулярные линзы. Устойчивость к процессам биодеградации в сравнении с зарубежными аналогами

Relevance. Due to the high demand for import substitution, the prospect of assessing the long-term results of implantation of domestic models of intraocular lenses (IOL) will determine their place among a wide range of models offered by modern manufacturers in our country and abroad. Purpose. To evaluate, in an in-vitro experiment on aging modeling, the resistance of new domestic IOLs to biodegradation processes in comparison with foreign analogues. Material and methods. 3 IOLs of the following models were taken: domestic IOLs made of hydrophobic acrylic: Citrine, Citrine TT, Citrine Action; domestic hydrophilic acrylic Aquamarine IOLs. Foreign hydrophobic acrylic IOLs of the AcrySof SN60AT model and hydrophilic IOLs of Rumex rAqua-4 were taken as reference. Before the experiment, the optical parameters of the studied IOLs were measured: optical power, modulation transmission function (MTF), Strel number. The induction of glistening was carried out as follows: IOLs immersed in a BSS solution were placed in an oven foR²4 hours with a temperature of 45 °С. Further, cooling was carried out to 37 °С foR².5 hours. IOL photofixation was performed at 80-fold magnification with an assessment of the degree of glistening. Optical parameters were repeatedly measured. Results. Glistening was not detected in Aquamarine IOL and Rumex rAqua-4. The 2nd and higher degree of glistening was not detected in any model of hydrophobic IOLs. The optical strength of all the studied IOLs changed in the range from 0.23 to 1.6%. MTF changes ranged from 0 to 3.7%. The number of Strel has changed in the range from 0 to 8.5%. The absence of glistening in hydrophilic IOLs can be explained by a more uniform distribution of water in the material. Differences in the degree of glistening in hydrophobic IOL models may be due to differences in production methods. The revealed changes in optical parameters are insignificant and do not exceed the limits of state standards. Conclusion. Domestic IOLs represent a worthy competition to foreign models, as they have advantages in terms of the availability of high-quality IOLs of aspherical design and a reduced degree of susceptibility to glistening. Key words: domestic intraocular lenses, hydrophobic acrylic, hydrophilic acrylic, glistening, inducing glistening, modeling of IOL aging

Video analysis of optic-haptic-interaction during hydrophobic acrylic intraocular lens implantation using preloaded injectors

ObjectiveTo compare the optic-haptic interaction of different hydrophobic acrylic IOLs after using six preloaded injectors.MethodsWe reviewed the video-recordings of procedures on a total of 388 eyes that underwent phacoemulsification and intraocular lens (IOL) implantation. For six preloaded injectors: multiSert (Hoya Surgical Optics) [System 1], TECNIS Simplicity (Johnson & Johnson Vision) [System 2], TECNIS iTec (Johnson & Johnson Vision) [System 3], AutonoMe (Alcon, Laboratories) [System 4], Bluesert (Carl Zeiss Meditec) [System 5], and Prosert (OphthalmoPro GmbH) [System 6], we noted in each case the time of IOL delivery and made a descriptive observation of IOL insertion and optic-haptic-interaction.ResultsWe defined standard haptic behavior where the haptics emerged “folded” from the injector and quickly recovered their pre-implantation appearance. The incidence where the leading haptic emerged in a deformed way for System 1 was 20%, System 2: 19%, System 3: 14%, System 4: 56%, System 5: 24% and System 6: 5%. For trailing haptic deformed behavior, the incidence was 36%, 6%, 4%, 8%, 18% and 2%, respectively for Systems 1 to 6. Optic-haptic adhesion occurred in 2% of cases for System 1, 44% for System 2, 52% for System 3, 48% for System 4, and 11% for System 6 (P < 0.05). Adhesion was not found with System 5.ConclusionsWe observed different deformed behavior for leading and trailing haptics in the six preloaded systems, some systems had as much as 52% optic-haptic adhesion.

Quantification of Straylight Induced by Silicone Oil Adherent to Intraocular Lenses of Different Materials

PurposeA complication of using silicone oil as an intraocular endotamponade is its adhesion to intraocular lenses (IOLs). Forward light scattering is a measure to quantify the optical disturbance caused by adherent oil droplets. We tested the straylight caused by silicone oil adhesion to different IOLs and examined whether an approved cleaning solution, F4H5, reverses the induced straylight. DesignAn experimental study. MethodsTwo hydrophobic acrylic IOL models and one hydrophilic model with a hydrophobic surface (n=8 per model: twenty-four lenses) had straylight measured before contact with silicone oils, providing a baseline for subsequent testing: twelve lenses with lighter-than-water silicone oil (Siluron 2000) and twelve with heavier-than-water oil (Densiron 68). The final measurement was after cleansing with F4H5 when we used scanning electron and light microscopy to detect surface changes. ResultsStraylight was majorly increased in IOLs with adherent silicone oil. (Baseline vs adherent oil median 3.1 [2.1, 3.9] and 39.7 [22.7, 87.8] deg2/sr, respectively, p<0.001). No difference was seen between heavier- and lighter-than-water silicone oils. Between IOL types, induced straylight varied significantly, with one hydrophobic model reaching the highest average straylight. F4H5 significantly reduced straylight values in all IOL types (median 9.4 [5.4, 13.8] deg2/sr). The microscopy revealed surface changes on the IOLs even after cleaning. ConclusionsSilicone oil adhesion to IOLs can induce amounts of straylight known to cause severe optical disturbance. F4H5 cleansing solution reversed straylight values to only slightly increased values. We found no difference in straylight formation between the lighter- and heavier-than-water silicone oils.

Preparation of hydrophobic acrylic intraocular lens materials using various crosslinking agents to reduce glistening

Glistening is the condensation of water that forms within the intraocular lens (IOL) materials. In this study, a new approach was attempted to reduce the glistening using various types and content of crosslinking agents. Hydrophobic acrylic IOL materials were prepared from 2-phenoxyethyl acrylate using three different crosslinking agents: ethylene glycol dimethacrylate (EGDMA), 1,4-butanediol diacrylate (BDDA), and glycerol 1,3-diglycerolate diacrylate (GDGDA). The IOL material cross-linked with the GDGDA showed the least amount of glistening. However, the IOL materials exhibited the largest amount of glistening when cross-linked with the EGDMA, indicating that the glistening decreased in the order of GDGDA > BDDA > EGDMA.

Transmittance characteristics of transparent hydrophobic acrylic foldable intraocular lenses that were in vivo for a prolonged period of time: A UV visible spectrophotometric study.

To record experimental data on the spectral transmittance characteristics of transparent hydrophobic acrylic foldable IOLs, which were in vivo for a prolonged period of time and explanted under clinical indications and also to compare the data with that of corresponding control and crystalline lens along with review of the relevant literature. Material and make of each of the explanted intraocular lenses (IOLs) as well as pre-explantation clinical status of the eyes were confirmed from the medical record. The transmittance of wavelength from 185 to 900 nm of each of the selected IOLs was measured using Shimadzu UV 2600 UV visible (UV-Vis) spectrophotometer in double-beam configuration and probe version 2.16 software. The data obtained were statistically analyzed. The mean transmittance of 12 clinically explanted IOLs at spectral range 300-700 nm was 49.5% ± SD 6.9%. This value was 10% and 38% less than the corresponding clear (59% ± SD 0.4%) and yellow (87.5% ± SD 0.4%) control, respectively. The mean transmittance of the analytes in the UV range was 43.3 ± SD 6.9%, and it was almost similar to the control. The data showed wide variations without good correlation, and it matches with the human crystalline lens at the age range of 50-60 years. All eyes were otherwise healthy, and none had age-related macular degeneration. In comparison with fresh IOL with a yellow filter, light transmittance at the spectral range 300-700 nm was found decreased in all the IOLs, which were in vivo for an average period of 12.25 ± 4.4 years. All IOLs transmitted variable amounts of UV radiation. More data are required for further analysis on the subject.

Early Clinical Experience with a New Hydrophobic Acrylic Single-Piece Monofocal Intraocular Lens.

To evaluate early clinical outcomes and adverse events (AEs) in cataract patients following implantation of a monofocal hydrophobic acrylic IOL with a new optimized non-constant aberration-correcting design (CT LUCIA 621P). This retrospective study included patients with visually significant cataracts who underwent implantation of the CT LUCIA 621P IOL. Refraction, corrected (CDVA) and uncorrected (UDVA) visual acuity of the last available visit were used in the analysis. Intraoperative and postoperative AEs of the cohort were reviewed. A total of 191 eyes of 133 patients with the mean age of 70.2±11.2 years were included in this study. The mean follow-up time of the last available visit was 1.7±1.3 months. The mean postoperative monocular UDVA was 0.09±0.16 logMAR (≈20/25), and 74.9% (143/191) eyes achieved ≥20/25 UDVA. The percentage of eyes with manifest spherical equivalent (MSE) within ±0.50D and ±1.00D of emmetropia was 84.8% (162/191) and 98.4% (188/191), respectively. Linear regression of attempted vs achieved MSE showed a tight relationship, with the coefficient of determination close to 1 (R2=0.99), indicating a very predictable refractive correction. The reported AEs were those typically expected after cataract surgery. There were no AEs related to intraoperative manipulation with the IOL/injector or to postoperative stability of the IOL in the capsular bag. No eye lost ≥2 lines of CDVA. The implantation of CT LUCIA 621P resulted in good refractive predictability and visual outcomes. No IOL-related adverse events were reported.

Hydrophilic Versus Hydrophobic Acrylic Intraocular Lens Implantation in Paediatric Cataract Surgery

Introduction: The selection of intraocular lens is still debatable in paediatric eye. Due to low cost and fewer intra-operative complication hydrophilic acrylic intraocular lens are implanted in volume in low income countries. There is lack of comparative study of this type of lens with hydrophobic lens in paediatric population.&#x0D; Aims: To compare the outcomes of hydrophilic acrylic lens and hydrophobic acrylic lens in paediatric cataract surgery.&#x0D; Methods: Out of 48 eyes included in the study, the Group A (n =24) eyes were implanted with acrylic hydrophilic intraocular lens, and the Group B (n =24) were implanted with acrylic hydrophobic intraocular lens. The children were evaluated pre, intra and postoperatively for different parameter.&#x0D; Results: The mean age was 6.6±2.7 years at the time of surgery. The most common type of cataract was zonular (58% in Group A and 50% in Group B). Postoperatively, corneal edema was seen in 7(29%) eyes in group A and in 2(8%) eyes in group B. The mean follow-up was 16.9±2.9 months. At one year, the position of the intraocular lens was in the capsular bag in 20 eyes (88.33%) and 24 eyes (100 %) in the group A and B, respectively. Clear visual axis was present in 22 eyes in Group A and 24 eyes in Group B. Posterior capsule opacification occurred in 12(50%) eyes in Group A and 6(25%) eyes in Group B. Two (8.3%) eyes in group A underwent surgical membranectomy due to visual axis opacification. The mean LogMAR visual acuity was 0.56 and 0.52 in group A and B respectively at one year.&#x0D; Conclusion: Hydrophilic acrylic intraocular lens are good alternative to hydrophobic intraocular lens in Nepal in the treatment of paediatric cataract.

Stainability of Acrylic Intraocular Lens With Brilliant Blue G: An In Vitro Study

To evaluate the stainability of several acrylic intraocular lens (IOLs) with Brilliant Blue G (BBG) in vitro. Clinically relevant, laboratory, experimental study. LS313MF15 as a hydrophilic acrylic IOL and X-70, W60R, CP2.2R, YP2.2R, XC1, and XY1 as hydrophobic acrylic IOLs were included in this study. Prepared acrylic IOLs were evaluated for staining via immersion for different periods in BBG solution with adjusted concentrations. In cases where IOLs were stained blue, the sustained release of BBG and IOL cross-sectional images were evaluated, as well as changes in the optical properties of the IOLs via spectrophotometry. All acrylic IOLs were stained with BBG in a BBG concentration- and staining time-dependent manner, with almost no sustained release of BBG observed. Lenses with a higher water content exhibited more pronounced staining, and BBG penetrated into the IOLs. A decrease in light transmittance with a peak wavelength of 610 to 620 nm was observed in blue-stained IOLs. LS313MF15 was markedly blue stained even with a short period of staining. Any acrylic IOL can be stained with BBG, but hydrophilic IOLs are particularly susceptible to blue staining. Precautions should be taken in surgeries requiring the use of BBG staining, and efforts should be made to ensure that BBG components are sufficiently washed out intraoperatively.

Evaluation of Visual Outcomes and 3-Month Refractive Stability of a New Hydrophobic Acrylic Intraocular Lens.

To determine the refractive stability of a new hydrophobic acrylic intraocular lens (IOL) when implanted bilaterally. This was a prospective, evaluator masked, single surgeon study of 58 eyes of 29 patients. Patients were bilaterally implanted with the Clareon monofocal IOL (CNA0T0, Alcon Vision LLC). Refractive stability was evaluated between 1 and 3 months postoperatively. At 3 months postoperatively, data were also collected for binocular uncorrected and distance corrected visual acuities at distance (4 m) and intermediate (80 cm and 66 cm) and binocular defocus curve. Postoperative refraction was statistically equivalent between 1 and 3 months postoperatively (p < 0.001). Mean postoperative uncorrected distance visual acuity was -0.01 ± 0.10 logMAR, and mean corrected distance visual acuity was -0.04 ± 0.06 logMAR. Mean postoperative uncorrected intermediate visual acuity was 0.16 ± 0.13 logMAR and 0.24 ± 0.14 logMAR at 80 cm and 66 cm, respectively. With distance correction in place, mean visual acuity at 80cm and 60cm was 0.16 ± 0.13 logMAR and 0.23 ± 0.14 logMAR, respectively. The Clareon monofocal IOL can provide stable refraction, excellent distance vision, and functional intermediate vision postoperatively.

Opacification of Hydrophilic Acrylic Intraocular Lenses: Overview of Laboratory Methods for Histological Analysis and Replication of IOL Calcification.

Opacification of intraocular lenses (IOLs) due to material changes is a serious complication that can compromise the good visual outcomes of uncomplicated cataract surgery. In hydrophobic acrylic IOLs, opacification can result from glistening formation, while in hydrophilic acrylic IOLs, there is a risk of calcification due to the formation of calcium phosphates within the polymer. Over time, various methods have been developed to investigate calcification in hydrophilic acrylic IOLs. The aim of this article is to provide an overview of standard histological staining and models used to simulate IOL calcification. Histological staining can be used to detect calcification and assess the extent of crystal formation. The development of in vivo and in vitro replication models has helped to identify the underlying pathomechanisms of calcification. In vivo models are suitable for assessing the biocompatibility of IOL materials. Bioreactors as an in vitro model can be used to investigate the kinetics of crystal formation within the polymer. The replication of IOL calcification under standardized conditions using electrophoresis allows for the comparison of different lens materials with respect to the risk of calcification. The combination of different analytical and replication methods can be used in the future to further investigate the pathomechanisms of calcium phosphate crystal formation and the influence of risk factors. This may help to prevent calcification of hydrophilic acrylic IOLs and associated explantation and complications.

Results of Implantation of a New Hydrophobic Acrylic Monofocal Intraocular Lens in a Preloaded Injector

Purpose. To evaluate clinical and functional results of implantation of a new hydrophobic acrylic monofocal IOL in a preloaded injector.Methods. The prospective study included 60 patients (66 eyes) after Hoya iSert® 250/251 IOL implantation (31 patients, 35 eyes, group 1) and a new Hoya Vivinex Multisert® XY1-SP IOL (29 patients, 31 eyes, group 2). The mean age was 75.1 ± 7.9 years. The mean follow-up period after surgery was 3.1 ± 0.4 months. IOL viscoimplantation was performed in 100 % of cases in group 1, in group 2 — in 45.1 % of cases, and in 54.9 % — hydroimplantation was performed. Intraoperatively, the size of the corneal incision was measured with a ruler before and after IOL implantation. IOL optic power was calculated with SRK/T and Barrett Universal formulas. In the postoperative period, surgically induced astigmatism was assessed.Results. In both groups, there was a statistically significant (p &lt; 0.05) increase of UCDVA from 0.28 ± 0.09 in the preoperative period to 0.70 ± 0.17 3 months after surgery in group 1 and from 0.24 ± 0.10 in the preoperative period to 0.84 ± 0.18 3 months after surgery in group 2. Slightly lower values of UCDVA in group 1 may be associated with a higher level of SIA in this group. Similar dynamics were shown for the BCDVA (from 0.52 ± 0.21 before surgery to 0.95 ± 0.19 after 3 months of follow-up in group 1 and from 0.55 ± 0.20 before surgery to 0.98 ± 0.21 after 3 months of follow-up in group 2). No differences were found between the studied groups. After IOL implantation, there was an increase in incision size to 2.40 ± 0.12 mm in group 1 and 2.10 ± 0.08 mm in group 2 (p = 0.04). In group 1, the mean SIA after 3 months of observation was 1.10 ± 0.16 D and in group 2, 0.48 ± 0.07 D (p = 0.0007).Conclusion. This study presents the first domestic experience with the implantation of a new monofocal hydrophobic acrylic Hoya Vivinex IOL in a Multisert® preloaded injector. A comparative analysis of implantation results with monofocal Hoya 250/251 IOLs in an Isert® injector was performed. The advantage of the new IOL implantation in reducing the incidence of surgically induced astigmatism was shown.

674 Cases of Late Postoperative Intraocular Lens Opacification of a Hydrophilic-Hydrophobic Acryl Intraocular Lens in Switzerland and Retrospective Opacification Risk Factor Assessment of 212 Cases

To report the prevalence of late postoperative opacification of a hydrophilic and hydrophobic acrylic intraocular lens (IOL) and to assess the risk factors in a subset of 212 eyes of patients referred to the University Eye Department in Basel, Switzerland. Retrospective case series. A survey was performed at all large ophthalmological clinics in Switzerland regarding exchanged Lentis LS-502-1 lenses, and the number of affected eyes was counted. Moreover, consecutive patients who were referred to a tertiary clinic between September 2015 and November 2016 with Lentis LS-502-1 opacification were investigated. Peri- and postoperative charts, medical history, and topical and systemic medications were assessed. A total of 674 opacified Lentis LS-502-1 lenses have been reported in Switzerland, and 212 consecutive eyes of 182 patients were included in the study. All IOLs had a similar pattern of opacification with a yellowish, diffuse appearance, and most of them showed a small, paracentral, roundish area that was less affected or not at all. Arterial hypertension (73%), hypercholesterolemia (34%), and diabetes (21%) were the main associated systemic diseases, and statins (34%) and betablockers (34%) were the main treatments used. The prevalence of IOL opacification was 9.9%. No associated systemic eye disease or medications could be detected, which was implicated in the opacification process. The reason for opacification remains unclear, but it seems to be unrelated to the patient's state; therefore, it is attributed to primary calcification.