Hydrophobic Intraocular Lens Research Articles

Comparing Optical Quality and Simulated Defocus Curves: A Head-To-Head Analysis of Hydrophilic and Hydrophobic Trifocal Intraocular Lenses.

AT ELANA is a recently introduced trifocal intraocular lens (IOL) made of a hydrophobic material. The new IOL's optical function was examined against an equivalent version made of hydrophilic material. . The David J. Apple Center for Vision Research, Heidelberg, Germany. Laboratory investigation. This optical investigation was conducted on +20D samples of the AT ELANA and the AT LISA tri. The area under the modulation transfer function (MTFa) served as a quality criterion. Simulated visual acuity (VA) and defocus curves across +1 to -3.5D range were derived from an empirical formula according to ANSI Z80.35. Susceptibility to photic phenomena was evaluated by assessing the light distribution around a point light source. The two models demonstrated comparable optical quality. While at distance, a 4% improvement was noted with the AT LISA tri, the AT ELANA's near MTFa was 5% higher. Only a marginal difference (1%) was noted at intermediate. Both IOLs reached simulated VA of 0.0 logMAR far vision, 0.10 logMAR at 80 cm, and 0.05 logMAR at 40 cm. Still, the near range was slightly expanded with the hydrophobic model. The light-spread profile was comparable between the two trifocals. The AT ELANA and the AT LISA tri demonstrated comparable optical quality and similarities in the potential for inducing photic phenomena. This study suggests that the hydrophobic trifocal IOL may provide visual range comparable to its hydrophilic counterpart. However, the asphericity change may facilitate the selection of a model that more effectively addresses specific corneal aberrations.

How do intraocular lens materials influence the outcome of cataract surgery?

This review summarizes the evidence on the effect of intraocular lens (IOL) material on the outcomes of cataract surgery, as well as on the surgical procedure itself. Differences in capsular biocompatibility between IOL materials lead to variations in capsular stability and posterior capsule opacification (PCO), while differences in uveal biocompatibility affect postoperative inflammatory response. Refractive outcomes are affected by both incision size and the rotational stability of toric IOLs. Small incision sizes favour hydrophilic IOLs. Rotational stability of hydrophobic and hydrophilic IOLs were comparable in recent studies. Visual outcomes are affected by chromatic aberrations, dysphotopsia, lens opacifications and PCO. Hydrophilic IOLs are associated with reduced chromatic dispersion. Hydrophobic IOL opacifications are caused by sub-surface glistenings, while hydrophilic IOL opacifications are due to surface calcifications. Some surgeries, including pars plana vitrectomy and lamellar corneal transplants, were shown to increase the risk of IOL calcifications, although the mechanism is still unknown. Hydrophilic IOLs have greater ease of manipulation, greater resistance to IOL damage, and higher uveal biocompatibility. Hydrophobic IOLs show better PCO prevention than hydrophilic IOLs, and should be preferred in highly myopic eyes where Nd:YAG capsulotomy might increase the risk of retinal detachment.

Geometry of Modern Presbyopia-Correcting Intraocular Lenses and Changes in Haptic-Capsular Bag Behavior According to Compression and Different Well Diameters: A Bench Study Using Computed Tomography.

The geometry of an intraocular lens(IOL), the design of the haptics, and the optic-haptic junction play a role in initial and long-term visual outcome after cataract surgery. Knowledge of the behavior of an implant in the capsular bag and under compression is of major importance. Our laboratory experiment analyzed in-depth the geometry of acrylic, single-piece, premium, presbyopia-correcting intraocular lenses and changes in haptic-capsular bag relationships according to capsular bag size using a range of compression well diameters. One hydrophilic (RayOne Trifocal® RAO603F) and three hydrophobic intraocular lenses (AcrySof IQ PanOptix®, Synergy DFR00V™, and AT ELANA 841P®) were scanned with computed tomography (CT) in a dry, uncompressed state for quantitative analyses of haptic and optic-haptic junction (OHJ) dimensions and qualitative assessment of geometry. In the second part of the experiment, CT was performed after sample placement into a series of compression wells (9.0, 10.0, 11.0, 11.5mm) for analyses of length of contact (LoC) between the haptics and the wells. Axial alignment and haptic-capsular bag relationships were assessed. The qualitative and quantitative evaluations highlighted differences in haptic and OHJ geometry and dimensions across the samples. The mid-zone of the optic was thickest in the hydrophilic sample (RayOne Trifocal® RAO603F) with a maximum of 0.880mm compared to the thinnest hydrophobic sample (AT ELANA 841P®) with 0.564mm. The AT ELANA 841P® showed the largest OHJ surface area (3.86mm2) and OHJ volume (0.60mm3) of the hydrophobic samples. The TECNIS Synergy DFR00V™ showed the thickest OHJ (0.51mm), while the AcrySof IQ PanOptix® showed the thinnest OHJ (0.21mm). The LoC values decreased with increasing well size for all tested samples. The AT ELANA 841P® showed the largest LoC and largest contact zones of hydrophobic samples in all wells. The laboratory experiments highlight differences in the haptics, the OHJ geometric characteristics, and behavior of samples in different well diameters. The results support the idea that specific IOL designs may have advantages or disadvantages depending on anatomical dimensions. We cannot make any classification or rating (good versus bad) for clinical practice on the basis these experimental results, as many other factors play a role. However, knowledge of IOL geometry seems important to select the best option in each individual case.

The uveitis–glaucoma–hyphema syndrome. Part 2. Comparative analysis of existing treatment methods effectiveness

Background: The uveitis–glaucoma–hyphema syndrome is a disease caused by iris injury due to extracapsular fixation of intraocular lens (IOL). ES Treatment involves IOL fixation or exchange. Aim: To compare the effectiveness of various surgical methods of uveitis–glaucoma–hyphema syndrome treatment. Materials and methods: The study group included 95 patients (95 eyes), divided into six subgroups depending on surgical treatment methods used: hydrophobic IOL exchange on hydrophilic model (HYDRO) with its transscleral fixation (n = 20); transscleral fixation (TSF) of native IOL (n = 18); hydrophobic IOL exchange on polymethylmethacrylate iris-claw IOL (CLAW; n = 22); iris-fixated IOLs (IRIS; n = 8); IOL immobilization with scleral bandage sutures (BS; n = 4); conservative treatment (CT; n = 23). The methods were compared using a scoring system. Results: The final score of surgical methods effectiveness is presented in descending order: HYDRO — 5.36 ± 1.05, TSF — 5.21 ± 1.80, CLAW — 3.87 ± 3.34, IRIS — 1.26 ± 4.41, BS — –0.74 ± 3.66, CL — –3.26 ± 2.51 (p 0.001). CONCLUSIONS: Uveitis–glaucoma–hyphema syndrome surgical management is a complex problem due to necessity of several interventions performing directed to eliminate the cause factor of recurrent hemorrhages — mechanical traumatization of iris by IOL. The comparison of various surgical techniques demonstrated the greatest effectiveness of HYDRO, TSF, and CLAW. Suture fixation of the IOL to the iris showed slightly less effectiveness. Using of bandage sutures for UGH treatment is inappropriate due to the high risk of relapse.

Structural integrity of eyelets in a hydrophobic intraocular lens with four-point scleral fixation.

Structural integrity of eyelets in a hydrophobic intraocular lens with four-point scleral fixation.

A study to compare the prevalence of posterior capsular opacity between patients implanted with hydrophobic acrylic intra ocular lens (IOL) versus hydrophilic acrylic intra ocular lens (IOL) in the diabetic and non-diabetic group following cataract surgery: A hospital based prospective study

: To study and compare the prevalence of posterior capsular opacity between patients implanted with hydrophobic acrylic IOL versus hydrophilic acrylic IOL in the diabetic and non diabetic group following cataract surgery. All patients with senile cataracts, whether they had diabetes or not, who visited a tertiary care hospital in Tamil Nadu between 2020 and 2022 were enrolled in this study after signing a written consent form. In this study, 200 patients underwent screening and were split into 4 equal groups.The PCO observation of patients in all 4 groups in the current study showed that Groups 3 and 4 with hydrophilic IOL found higher incidences of PCO than Groups 1 and 2 with hydrophobic IOL. In our study, more PCO was reported with hydrophilic IOL with known (Group 3) and unknown (Group 4) cases of diabetes. Regardless of the patient's level of diabetes during the course of a year-long follow-up, hydrophobic acrylic IOLs showed a greater decrease in PCO rates than hydrophilic acrylic IOLs.

A case series on small incision cataract surgery + PMMA IOL with primary posterior capsulorrhexis: A safe and cheaper alternative in management of pediatric cataracts

Pediatric cataracts, a significant cause of childhood blindness, present pronounced challenges in low-income countries where conventional phacoemulsification with hydrophobic foldable IOLs may be economically unfeasible. In resource-limited settings, the conventional method of employing phacoemulsification with hydrophobic foldable IOLs is often impractical. This case series explores an economically pragmatic alternative, centering on Small-incision cataract surgery (SICS) paired with rigid polymethyl methacrylate (PMMA) intraocular lenses (IOLs). This study delves into the visual outcomes of SICS with in-the-bag PMMA IOLs, Primary Posterior Capsulorrhexis (PPC), and anterior vitrectomy to mitigate Posterior Capsule Opacification (PCO) formation in the Visual Axis (VA). The evaluation, conducted at specific postoperative intervals spanning from Post-op Day 01 to the 6th month, provides a comprehensive understanding of the efficacy and safety of this approach. Findings underscore PMMA IOLs as both durable and cost-effective substitutes, with an emphasis on SICS with PPC as a reliable technique for cataract removal. This research delivers a practical solution to enhance visual outcomes, tackling the distinct challenges confronted in resource-limited settings and contributing to the broader global endeavor to alleviate preventable childhood blindness.

Higher phosphate concentrations as in aqueous humor of diabetic patients increase intraocular lens calcification

BackgroundClinical evidence suggests an association between phosphate concentrations in aqueous humor and the risk of intraocular lens (IOL) calcification. To test this hypothesis the influence of different phosphate concentrations on IOL calcification was evaluated in an in vitro electrophoresis model.Methods20 IOLs of two hydrophilic IOL models (CT Spheris 204, Zeiss; Lentis L-313, Oculentis) and one hydrophobic control IOL model (Clareon CNA0T0, Alcon) were exposed to physiologic and elevated phosphate concentrations, similar to diabetic aqueous humor. IOL calcification was analyzed by alizarin red staining, von Kossa staining, scanning electron microscopy, energy dispersive x-ray spectroscopy and transmission electron microscopy with electron diffraction.ResultsHigher phosphate concentrations were associated with IOL calcification. Analyses of IOL surfaces and cross-sections documented calcification in no CT Spheris and 4 Lentis IOLs following exposure to 10 mM Na2HPO4, compared with 7 and 11 positive analyses following exposure to 14 mM Na2HPO4, respectively. Furthermore, a clear association between IOL calcification and the duration of electrophoresis was demonstrated, confirming increased phosphate concentrations and duration of exposure as risk factors of IOL calcification.ConclusionsFindings suggest that higher phosphate concentrations in aqueous humor, as seen in diabetic patients, contribute to an increased IOL calcification risk, potentially explaining clinical observations showing an increased risk of IOL calcification in patients with diabetes.

The uveitis–glaucoma–hyphema syndrome. Part 1. Pathogenesis, clinical features, diagnosis

BACKGROUND: The uveitis–glaucoma–hyphema (UGH) syndrome was first described in 1978 as a complication of anterior chamber polymethyl methacrylate intraocular lenses implantation. Introduction into practice of foldable intraocular lenses with intracapsular fixation has reduced the incidence of UGH. However, this complication still occurs today, especially with extracapsular intraocular lens fixation. AIM: The aim of this study is to describe “uveitis–glaucoma–hyphema” syndrome pathogenesis, clinical features, and diagnosis. MATERIAL AND METHODS: A retrospective analysis of medical data for 2017–2021 identified 100 patients (101 eyes) diagnosed with UGH syndrome, they made up the study group. Complaints, medical history, biomicroscopy, visual acuity and intraocular pressure were assessed. 37 patients underwent anterior segment ultrasound biomicroscopy using the Accutome UBM Plus (USA). RESULTS: The occurrence of UGH syndrome is at least 0.19%. The leading UGH syndrome risk factor was intraocular lens material. In 49% of cases these were AcrySof hydrophobic intraocular lenses. The second UGH risk factor was extracapsular (mixed and sulcus) intraocular lens fixation, occurring, according to ultrasound biomicroscopy, in 54 and 19% of cases, respectively. The most significant diagnostic UGH sign was hyphema (93%). Ocular hypertension was detected in 66%, and uveitis in 57% of cases. CONCLUSIONS: The main UGH syndrome manifestations are hyphema and iris transillumination after phacoemulsification complicated by posterior capsule rupture with extracapsular hydrophobic intraocular lens fixation. The most informative instrumental method to assess intraocular lens position is ultrasound biomicroscopy.

Visual axis reopacification after Nd:YAG laser posterior capsulotomy

Posterior capsular opacification (PCO) and anterior hyaloid face opacification are the two possible causes of visual axis opacification after cataract surgery, of which PCO is more common in adults. This is treated by neodymium-doped yttrium aluminum garnet (Nd:YAG) laser-assisted disruption of the opacified posterior capsule/membrane. Recurrence of visual axis opacification after a successful Nd:YAG laser posterior capsulotomy is infrequent. We report a case of visual axis reopacification after a successful Nd:YAG capsulotomy for PCO in an adult with no history of systemic or ocular disease who underwent phacoemulsification and an acrylic hydrophobic intraocular lens implantation. Patients should be explained about this possibility when undergoing Nd:YAG capsulotomy.

Refractive and Visual Outcomes Using a Trifocal, Diffractive, Hydrophobic Intraocular Lens in Japanese Eyes.

To report the refractive and visual outcomes after implantation of a trifocal, diffractive, hydrophobic intraocular lens (IOL) in Japanese eyes following cataract surgery. A total of 45 eyes implanted with FineVision HP IOLs (Beaver-Visitec International, Inc. USA) were enrolled in this retrospective study. The clinical outcomes assessed after 3-months were refraction and monocular logarithm of the minimum angle of resolution (LogMAR) uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA), and distance-corrected near visual acuity (DCNVA) at 40 cm. 97.78% of the eyes were within ±0.50D of spherical equivalent and all of them were within ±1.00D (mean: -0.00±0.22 D, with 75.56% within ±0.13D), while 91.11% of the eyes had ≤0.50D residual astigmatism and all of them had ≤1.00D (mean: -0.08±0.24D, with 88.89% ≤0.25D). UDVA and CDVA showed mean values of -0.05±0.07 logMAR and -0.07±0.06 logMAR, respectively. 86.67% and 95.56% of the eyes had ≥20/20 UDVA and CDVA, respectively, with 100% achieving ≥20/25 for both UDVA and CDVA. At 80 cm, the mean monocular logMAR UIVA and DCIVA were 0.18±0.14 and 0.14±0.14, and at 66 cm the values were 0.20±0.15 and 0.19±0.15, respectively. At 80 cm 20% of the eyes had ≥20/25 DCIVA and 60% had ≥20/32 DCIVA. These values changed to 15.56% and 40% of the eyes at 66 cm. In terms of near vision, the mean monocular logMAR UNVA and DCNVA were 0.04±0.10 and 0.03±0.10, respectively. 53.33% of the eyes had ≥20/20 UNVA and DCNVA, with 86.67% achieving ≥20/25 UNVA and DCNVA. The FineVision HP trifocal diffractive IOL provided accurate refractive outcomes with good visual acuity at different distances in Japanese eyes.

Glare prediction and mechanism of adaptation following implantation of hydrophilic and hydrophobic intraocular lenses.

Glare is a known side effect of intraocular lens (IOL) implantation, affected principally by IOL material and optics, although it is reported subjectively to decrease in impact with time. However, little objective data have been published on changes over time, how these relate to subjective reports, and whether those who will report greater glare symptoms can be predicted prior to IOL implantation. A total of 32 patients (aged 72.4 ± 8.0 years) with healthy eyes were implanted bilaterally with hydrophilic 600s (Rayner, Worthing, UK) or hydrophobic Acrysof (Alcon, Texas, USA) acrylic IOLs (n = 16 each, randomly assigned). Each patient reported their dysphotopsia symptoms subjectively using the validated forced choice photographic questionnaire for photic phenomena, and halo size resulting from a bright light in a dark environment was quantified objectively in eight orientations using the Aston Halometer. Assessment was performed binocularly pre-operatively and at 1, 2, 3, and 4 weeks after IOL implantation. The study was carried out at the National Health Service Ophthalmology Department, Queen Elizabeth Hospital, Birmingham, UK. Visual acuity (average 0.37 ± 0.26 logMAR) did not correlate with subjective glare (r = 0.184, p = 0.494) or objective glare (r = 0.294, p = 0.270) pre-surgery. Objective halo size (F = 112.781, p < 0.001) decreased with cataract removal and IOL implantation and continued to decreased over the month after surgery. Subjective dysphotopsia complaints (p < 0.001) were also greater pre-surgery, but did not change thereafter (p = 0.228). In neither case was there a difference with IOL material (p > 0.05). It was not possible to predict post-surgery dysphotopsia from symptoms or a ratio of symptoms to halo size pre-surgery (p > 0.05). Subjective dysphotopsia and objective halos caused by cataracts are greatly reduced by implantation of IOL after cataract removal causing few perceivable symptoms. However, objective measures are able to quantify a further reduction in light scatter over the first month post-IOL implantation, suggesting that any subjective effects over this period are due to the healing process and not due to neuroadaptation.

Analysis of intraocular lens decentration and tilt after femtosecond laser-assisted cataract surgery using swept-source anterior optical coherence tomography

ObjectiveTo evaluate and compare the magnitude of intraocular lens (IOL) decentration and tilt following conventional and femtosecond laser-assisted cataract surgery (FLACS) using swept-source anterior optical coherence tomography (SS-OCT). MethodsIn this retrospective observational study, we enrolled patients who underwent conventional cataract surgery or FLACS with the implantation of hydrophobic 1-piece monofocal IOL. The magnitude of IOL decentration and tilt were measured using SS-OCT. Visual acuity, intraocular pressure, spherical equivalent, axial length, contrast sensitivity, and satisfaction questionnaire were evaluated before and one-month post-surgery. Additionally, postoperative internal cylinder measurements were obtained using a wavefront aberrometer. Correlation factors between each parameter and IOL decentration or tilt were analyzed. ResultsThis study included 100 eyes from 100 patients. Mean IOL decentration and tilt were 0.21 ± 0.13 mm and 5.01 ± 1.49°, respectively. Conventional cataract surgery (versus FLACS, P = 0.001) and male sex (versus female, P = 0.047) were significantly correlated with higher postoperative decentration. Preoperative lens diameter (P < 0.001), preoperative lens tilt (P = 0.007), and preoperative intraocular pressure (P = 0.027) were correlated with higher postoperative tilt. Fifty eyes that underwent FLACS demonstrated mean postoperative decentration of 0.21 ± 0.13 mm and tilt of 4.64 ± 1.48°. Compared with the conventional surgery group, the FLACS group significantly differed in postoperative decentration (0.30 ± 0.12 mm, P < 0.001) but not in tilt (5.03 ± 1.35°, P = 0.173). Postoperative visual acuity did not significantly differ between the two groups. ConclusionPatients who underwent FLACS demonstrated better IOL decentration and tilt than those who underwent conventional cataract surgery one-month post-surgery. However, differences in IOL decentration and tilt did not affect postoperative visual acuity.

Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes

BackgroundTo describe and analyze the real-life refractive, functional and safety outcomes of the Clareon® intraocular lens (IOL) after 3 years.MethodsData was collected retrospectively for observational purposes between July 2017 and December 2019 in the ophthalmology department of Desgenettes military hospital in Lyon, France. Eyes that underwent cataract surgery with Claeron® implantation were consecutively included. Patients with a systemic or ocular condition that could affect the visual outcome were excluded. Postoperative corrected (CDVA) and uncorrected (UDVA) distance visual acuities as well as capsule and IOL transparency were assessed at 1 month and 3 years.ResultsA total of 326 eyes were analyzed at one month and 191 eyes were reassessed at the 3-year follow-up visit. At 3 years, the mean CDVA was 0.003 LogMAR (95% confidence interval [CI]: -0.003 to -0.01) and the mean UDVA was 0.075 (95% CI: 0.054 to 0.095). Three quarters of the patients had an UDVA ≥ 0.097 logMAR (20/25 Snellen equivalent) and 50% had an UDVA ≥ 0 (20/20). The absence of glistening was reported in 95.3% of cases and 4.7% [9] of patients experienced a clinically significant posterior capsular opacification (PCO) for which Nd:YAG treatment was required.ConclusionsThis real-life study reports high-performance and stable long-term refractive outcomes of the Clareon® IOL with good safety in terms of PCO and glistening.

Reverse 4-Flanged Technique for Intrascleral Fixation of a Foldable Hydrophobic Intraocular Lens in the Absence of Capsular Support Through a 2.2-mm Corneal Incision.

The purpose of this study was to describe a modified technique for sutureless intrascleral intraocular lens fixation in patients without capsular support: the reverse 4-flanged technique. A 2.2-mm corneal incision was made for aphakic patients. The 6-0 polypropylene sutures were threaded through a 30-gauge needle outside the eye. An MDJ injector was employed to insert the intraocular lens into the eye. A suture-needle snare with 7-0 polypropylene was used to exteriorize the superior end of the sutures through the sclerotomy. The 6-0 polypropylene was heated with a cautery to create the flanges. Nine eyes of nine patients underwent the reverse 4-flanged technique. The median follow-up time was 182 days (range 174-195). Best-corrected distance visual acuity improved from 20/400 [hand movement-20/33] to 20/120 [20/400-20/21]. No vitreous hemorrhage, retinal detachment, endophthalmitis, intraocular lens luxation, or flange exposure was recorded during the follow-up. The reverse 4-flanged technique maintains the advantages of the original 4-flanged technique in terms of intraocular lens stability while reducing the incision size and surgical maneuvers performed inside the eye. This modification promises to be a reliable, safe, and relatively simple technique to correct aphakia in the absence of capsular support.

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.

IOL's material and PCO

Posterior capsular opacification (PCO) is the most common of late post‐surgery complications and can lead to reduced visual acuity, diplopia, or glare. The different types of material used in intraocular lenses (IOLs) plays a significant role in possible post‐surgery complications, such as anterior capsule opacification (ACO) and phimosis, posterior capsule opacification (PCO), and the formation of IOL opacification. PCO incidence increases with time and varies from 10% to 50%. The incidence of PCO will rise in the nearest future since IOLs will stay longer in the eye, as people's lifespans are increasing. It was shown that hydrophilic IOLs had significantly more and denser PCO than hydrophobic or silicone IOLs. The higher incidence of PCO formation in hydrophilic than in hydrophobic IOLs should be considered as an important medical and health economic issue when choosing the IOL for implantation.

Hydrophobic Trifocal Toric Intraocular Lens Outcomes in Japanese Eyes After Cataract Surgery.

To analyze the refractive and visual outcomes following cataract surgery and implantation of a new hydrophobic trifocal toric intraocular lens (IOL) in Japanese eyes with different degrees of corneal astigmatism. A total of 66 eyes from 39 patients implanted with a FineVision HP Toric IOL (Beaver-Visitec International Inc) were analyzed retrospectively. The main outcome measures considered were refraction, monocular uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and distance-corrected intermediate visual acuity (DCIVA) at 80 and 66 cm, uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) at 40 cm. Eyes were evaluated at three months post-surgery. Sixty-five eyes (98.48%) were within ±0.50D of spherical equivalent, and all were within ±1.00D (mean: 0.00±0.21D). Moreover, 63 eyes (95.45%) had ≤0.50D of residual astigmatism, and all had ≤1.00D (mean: -0.08±0.23D). Similarly, 58 (87.88%) and 60 eyes (90.91%) had ≥20/20 UDVA and CDVA, respectively, with 65 (98.48%) and 66 eyes (100%) achieving ≥20/25 UDVA and CDVA, respectively. In addition, 28 (42.42%) and 23 eyes (34.85%) had ≥20/25 DCIVA at 80 and 66 cm, respectively, with 49 (74.24%) and 52 eyes (78.79%) achieving ≥20/32 DCIVA at 80 and 66 cm, respectively. Finally, 39 (59.09%) and 40 eyes (60.61%) had ≥20/20 UNVA and DCNVA, respectively, with 58 (87.88%) and 59 eyes (89.39%) achieving ≥20/25 UNVA and DCNVA, respectively. Our study shows that implantation of the new hydrophobic FineVision HP Toric IOL results in accurate refractive outcomes, with good visual acuity at different distances, in Japanese eyes.

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

Comparison of the Incidence of Nd:YAG Laser Capsulotomy Based on the Type of Intraocular Lens.

Background and Objectives: Posterior capsular opacification (PCO) is the most common long-term complication of successful cataract surgery and can cause visual impairment. We aimed to investigate the effects of intraocular lens (IOL) characteristics on PCO by comparing the incidence of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for different types of intraocular lenses. Materials and Methods: A retrospective analysis was performed on 2866 eyes that underwent cataract surgery between January 2010 and December 2017, with at least 5 years of follow-up. The IOLs used for surgery were the hydrophobic lenses SN60WF (Alcon, Fort Worth, TX, USA), ZCB00 (Johnson & Johnson Vision, Santa Ana, CA, USA), and MX60 (Bausch & Lomb, Rochester, NY, USA), and the hydrophilic lens MI60 (Bausch & Lomb, Rochester, NY, USA). We analyzed the incidence of Nd:YAG laser capsulotomy according to the type of IOL used. Results: The incidence of Nd:YAG laser capsulotomy was significantly higher with MI60 lenses (31.70%, 175/552 eyes) compared to SN60WF (7.90%, 113/1431 eyes), ZCB00 (10.06%, 64/636 eyes), and MX60 (10.57%, 13/123 eyes; p < 0.001) lenses. The incidence of Nd:YAG laser capsulotomy was significantly lower with the hydrophobic IOLs (8.68%, 190/2190 eyes) than with the hydrophilic IOL (31.70%, 175/552 eyes; p < 0.001). Over time, the rate of increase in the cumulative number of Nd:YAG laser capsulotomy cases was the highest with MI60. The cumulative rate of Nd:YAG laser capsulotomy during the first 3 years was 4.90% with SN60WF (70/1431 eyes), 6.76% with ZCB00 (43/636 eyes), 8.94% with MX60 (11/123 eyes), and 26.10% with MI60 (144/552 eyes) lenses. Conclusions: The incidence of PCO is influenced by the material of the IOLs. The hydrophilic IOL was associated with a higher rate of Nd:YAG laser capsulotomy than the hydrophobic IOLs, with a shorter time to Nd:YAG laser capsulotomy.