Sensar Intraocular Lens Research Articles

Evaluation of the Effectiveness of Preloaded IOL Injectors in Surgical Time

Background: The implantation of the intraocular lens (IOL) is still subject to error and complication, as it can result in traumatic opening of the IOL leading to rupture of the posterior capsule and zonular dialysis, it takes time to train paramedic teams to assemble such IOLs with the manual injectors. Moreover, there is a potential risk of comtamination and endophthalmitis as there is manipulation of the IOL and cartridge. The preloaded IOLs tend to reduce those unwanted results and may optimize the surgical time. Purpose: The aim of this study is to compare the effectiveness and implantation time between three injectors and three intraocular lenses, two pre-loaded and one conventional. Methodology: Videos of thirty patients undergoing cataract surgery from December 2019 to December 2020 at the Hospital Oftalmologico de Brasilia (HOB), Brasilia, Brazil were included in this observational, analytical retrospective study, non randomized. All patients had their surgeries recorded, from which the time of injection and opening of the intraocular lens (IOL) was extracted, 20 eyes were implanted with preloaded intraocular lens, and 10 eyes with conventional IOL implant. The patients were divided into three groups with similar eye characteristics. The first received the AutonoMeTM (CE) injector with the Clareon® IOL, the second the IsertTM injector (I) with the Hoya® IOL, and the third was injected with Johnson & Johnson Platinum 1 Series injector used to deliver Sensar® One AAB00 lens. The Welch test and Tukey’s Post Hoc test were used in the statistical analysis. Results: It was observed that there was a statistical significance regarding the presence of a haptic stuck (5 Clareon vs 0 Sensar and Hoya), between the mean opening time of the IOL optics Sensar One, Hoya and Clareon (25.00 vs 31.40 vs 11.70 s, p < 0.001) and between the total time (the injection time more the opening time of the IOL) in relation to Hoya and Clareon lenses (39.50 s vs 19.60 s, p < 0.001); the total time of the Sensar IOL was 31.30 s. The opening time of the IOL optics was significantly longer for the Sensar One and Hoya groups compared to Clareon group, and the total time of Hoya group was significantly longer compared to the total time of the Clareon group. Conclusion: The study demonstrated that the choice of injector and IOL set can significantly affect the total time of IOL implantation. However, there was no difference regarding complications and collateral damage depending on the set chosen for the implant.

Comparing the outcome of intraocular lens implantation with or without posterior optic capture in pediatric cataract surgery

Purpose To evaluate the outcome of intraocular lens (IOL) implantation with posterior optic capture versus in-the-bag implantation in pediatric cataract surgery. Setting Ain Shams University Hospital and Research Institute of Ophthalmology. Design It is a prospective, comparative clinical study. Patients and methods Thirty eyes with developmental cataract underwent primary cataract extraction and IOL implantation of hydrophobic acrylic multipiece Sensar IOL AR40e. In all cases, anterior and posterior continuous curvilinear capsulorrhexis, lens aspiration, and anterior vitrectomy were performed. IOL was implanted in the ciliary sulcus, and the optic was captured in both anterior and posterior capsulorrhexis in group A (15 eyes) and implanted in the bag without capture in group B (15 eyes). Visual acuity, visual axis opacification, red reflex, intraocular pressure, centration, and complications were all assessed. Results The mean age of children was 5.3±2.93 years. At 6 months of follow-up, the mean postoperative corrected distant visual acuity was 0.69±0.19 and 0.65±0.23 in groups A and B, respectively. The mean clear central zone was 4.29±0.24 and 3.6±0.55 mm in groups A and B, respectively (P=0.001). The mean IOL decentration measured in mm was 1.61±1.17 and 0.86±0.28 SD in groups A and B, respectively (P=0.003). There were no postoperative complications in all cases. Conclusion Placement of IOL haptics in the ciliary sulcus while capturing the optic through the posterior continuous curvilinear capsulorrhexis provides more central clarity of the visual axis, however IOL decentration was more common.

Refractive Results: Safety and Efficacy of Secondary Piggyback Sensar™ AR40 Intraocular Lens Implantation to Correct Pseudophakic Refractive Error.

In this study we evaluate the visual outcomes, safety, efficacy, and stability of implanting of second sulcus intraocular lens (IOL) to correct unsatisfied ametropic patients after phacoemulsification. Methods. Retrospective study of 15 eyes (15 patients) underwent secondary intraocular lens implanted into the ciliary sulcus. The IOL used was a Sensar IOL three-piece foldable hydrophobic acrylic IOL. The first IOL in all patients was acrylic intrabagal IOL implanted in uncomplicated phacoemulsification surgery. Results. Fifteen eyes (15 patients) were involved in this study. Preoperatively, mean log⁡MAR UDVA and CDVA were 0.88 ± 0.22 and 0.19 ± 0.13, respectively, with a mean follow-up of 28 months (range: 24 to 36 months). At the end of the follow-up, all eyes achieved log⁡MAR UDVA of 0.20 ± 0.12 with postoperative refraction ranging from 0.00 to −0.50 D of attempted emmetropia. Conclusions. Implantation of the second sulcus SensarAR40 IOL was found to be safe, easy, and simple technique for management of ametropia following uncomplicated phacoemulsification.

A Comparison of Accommodation Amplitudes of Three Different Acrylic Intraocular Lenses

Aim : To assess the accommodative amplitudes of three different foldable acrylic intraocular lenses (IOLs) by measuring with photorefractor Plusoptix CR03 (Plusoptix GmbH, Nuernberg, Germany). Methods: Fifty five pseudophakic eyes of 46 patients (mean age 65.25±10.63 years) were analyzed one month after uneventful phacoemulsification and IOL implantation surgery. Rayner Centerflex (C-Flex) (n=17), AcyrSof MA60BM (n=17), Sensar AR40e (n=21) IOLs were implanted. An objective, dynamic measurement technique with R mode of Plusoptix CR03 device was used to measure accommodation. Accommodation was measured at near distance (0.33m) and far distance (5m). Results: Accommodation amplitudes (mean ± SD) measured with photorefractor at near distance in Rayner, AcyrSof and Sensar groups were 1.45±0.76 diopter (D), 2.82±1.88 D, 2.44±1.02 D, respectively. Accommodative response of AcyrSof and Sensar IOLs was greater than Rayner IOL significantly (p=0.027 and p=0.004, respectively). At far distance,

Detection of pyrogens adsorbed to intraocular lenses: Evaluation of limulus amoebocyte lysate and in vitro pyrogen tests

To determine the ability of the limulus amoebocyte lysate (LAL) assay and the in vitro pyrogen test (IPT) to detect pyrogens adsorbed to intraocular lenses (IOLs). Berlin Eye Research Institute, Berlin, Germany. Fifteen of each of the following IOLs were used: MicroSil MS 612 ASP, AcrySof SA60AT, Superflex, Sensar, XACT, and LS-106 IOLs. The challenge organism suspensions were 10(3) CFU/mL and 10(4) CFU/mL Escherichia coli, 10(3) CFU/mL and 10(4) CFU/mL Pseudomonas putida, and 10(5) CFU/mL and 10(6) CFU/mL Staphylococcus epidermidis. Two IOLs of each model were incubated at room temperature for at least 2 days in 0.6 mL of 1 of the suspensions. They were then gamma sterilized. The extract of 1 IOL was tested with the LAL assay; the other IOL was tested with the IPT. The LAL was negative for all incubated IOLs. The IPT was positive for all IOLs incubated in E coli and P putida suspensions, with the MicroSil MS 612 ASP, AcrySof SA60AT, XACT, and LS-106 IOLs showing a severe reaction. The Superflex and Sensar IOLs had a slight to moderate response for lower bacterial concentrations and a moderate to severe response for higher concentrations. For S epidermidis, all IOLs showed a slight IPT response except XACT IOLs, which showed a nonpyrogenic response. Results indicate that the LAL test may fail to detect pyrogens adsorbed to IOLs and the IPT reliably detects pyrogens with a dose-dependent response. This has relevance in the investigation of toxic anterior segment syndrome outbreaks.

Visual performance of aspherical and spherical intraocular lenses: Intraindividual comparison of visual acuity, contrast sensitivity, and higher-order aberrations

To intraindividually compare visual performance in terms of photopic high-contrast visual acuity (HCVA), mesopic HCVA, mesopic low-contrast visual acuity (LCVA), and contrast sensitivity (CS) in patients after implantation of either an aspherical or a spherical intraocular lens (IOL). Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. Forty eyes of 20 patients were randomized to implantation of an aspherical IOL (Tecnis Z9000, AMO) in 1 eye and a spherical IOL (Sensar AR40e, AMO) in the other eye. Three to 4 months postoperatively, photopic HCVA (270 cd/m(2)) was measured with the observer-independent Frankfurt-Freiburg Contrast and Acuity Test System (FF-CATS) and high-mesopic HCVA and LCVA (8 cd/m(2)) were measured with Early Treatment Diabetic Retinopathy Study charts. CS was assessed with the FF-CATS under photopic (167 cd/m(2)), high-mesopic (1.67 cd/m(2)), and low-mesopic (0.167 cd/m(2)) luminance conditions with and without glare. For each individual eye, higher-order wavefront aberrations were reconstructed for a physiological mesopic pupil diameter. Intraindividual differences (Delta(i)) in visual acuity, contrast sensitivity, and higher-order aberrations (HOAs) were calculated, and the influence of age and Delta(i) HOA on Delta(i) contrast sensitivity (logCS) under high-mesopic conditions was investigated using multiple regression analysis. There were no statistically significant differences between the Tecnis IOL and the Sensar IOL in visual acuity measurements or contrast sensitivity measurements. For physiological mesopic pupil diameter, primary spherical aberration (Z(4)(0)) was significantly lower in the Tecnis group (P<.001). For all parameters studied except Z(4)(0), the Delta(i) values were distributed around zero. Multiple regression analysis showed only a partial influence of Delta(i) Z(4)(0) on Delta(i) logCS (adjusted R(2) = 0.49) but did not show any influence of age, coma-like aberration, or residual HOA. Although Z(4)(0) was significantly lower in the eyes with the aspherical IOL, no statistically significant differences were found between aspherical and spherical IOLs in LCVA, HCVA, and contrast sensitivity. Statistical analysis of intraindividual contrast sensitivity differences showed that in most patients, this Z(4)(0) difference was too low to have an effect on contrast sensitivity.

Comparison of posterior capsule opacification between fellow eyes with two types of acrylic intraocular lens

To compare the degree of posterior capsule opacification (PCO) and visual function between fellow eyes that received two different types of hydrophobic acrylic intraocular lenses (IOLs). Forty-five patients underwent bilateral phacoemulsification and implantation of an Alcon AcrySof IOL (MA60AC) in one eye and an AMO Sensar IOL (AR40e) in the fellow eye. The PCO density value was measured using the Scheimpflug videophotography system at 1, 6, 12, and 24 months after surgery. The incidence of eyes that required a neodymium:YAG (Nd:YAG) laser capsulotomy, visual acuity, and contrast sensitivity with and without a glare source were also examined. The mean PCO value did not show a significant increase in either the AcrySof MA60AC or Sensar AR40e IOL groups, and was similar between the two groups throughout the 24-month follow-up period. The incidence of Nd:YAG laser capsulotomy was also the same between the groups. No significant difference was found in mean visual acuity between the two IOL groups during the follow-up, and there was no significant difference in photopic or mesopic contrast visual acuity with and without a glare source at 1 and 24 months after surgery. The degree of PCO in eyes with an AcrySof IOL are almost the same as that in eyes with a Sensar IOL, with the results that visual acuity and contrast sensitivity with and without glare are similar.

Choice of intraocular lens may not affect refractive stability following cataract surgery

Abstract Purpose: To assess whether the choice of an intraocular lens (IOL) with rigid haptics (Sensar) or an IOL with pliable haptics (Acrysof) has an effect on refractive stability following cataract surgery. Methods: Seventy‐three patients were recruited consecutively as they returned for their 6‐month visit following cataract surgery. There were 37 patients who had received an Acrysof IOL and 36 who had received a Sensar IOL. Each patient had their refractive error measured at the 1‐month postoperative visit. At the 6‐month follow‐up visit, refraction was repeated. The change in refractive error was then compared between IOL groups and other factors that may affect postoperative refractive stability including preoperative refraction, axial length, keratometry, wound type and wound meridian. Results: An Acrysof IOL showed minimal myopic movement, whereas a Sensar IOL was more likely to move hypermetropically. However, this difference was not statistically significant (t = 1.92; P = 0.06). The magnitude of the shift in spherical equivalent in either direction for the Acrysof group was 0.37 ± 0.35 D and for the Sensar group was 0.28 ± 0.31 D. Again, this difference was not statistically significant (t = 1.17; P = 0.25). However, preoperative anterior chamber depth was associated with postoperative refractive shift (t = 2.66; P = 0.009). Furthermore, patients with a scleral wound showed a small against‐the‐rule shift in cylindrical refractive error. No other factors were associated with postoperative refractive shift amongst the sample. Conclusions: There were no clinically significant differences in postoperative refractive stability between the Acrysof and Sensar groups. However, preoperative anterior chamber depth was associated with the magnitude of shift in spherical equivalent.

Unfolder lens injection system with acrylic intraocular lenses: Retrospective study

Purpose To examine the efficacy of using the Unfolder® Sapphire series system (Allergan) for implanting acrylic intraocular lenses (IOLs) with a 6.0 mm optic (Sensar® AR40, Allergan) Setting Ambulatory day-surgery center. Methods Phacoemulsification was performed using topical anesthesia. The Unfolder injection system was used to insert a Sensar AR40 acrylic IOL. Data on complications and the success of implantation were collected retrospectively. Results Two hundred two consecutive patients having implantation of the Sensar IOL with the Unfolder system were examined. Three problems related to the Unfolder injector were identified. Another patient required an anterior vitrectomy, sulcus IOL implantation with the Unfolder, and optic capture; the complication was not related to the Unfolder system. Sulcus implantation was relatively easy with the Unfolder. Conclusion Implantation of the Sensar AR40 IOL with the Unfolder system was easy to perform, and no serious complications occurred.

In vitro comparison of glistening formation among hydrophobic acrylic intraocular lenses

Purpose: To compare glistening formation induced by temperature stressing in vitro among hydrophobic acrylic intraocular lenses (IOLs) available in the United States. Setting: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. Methods: Wagon Wheel (WW) packaged 1-piece AcrySof® IOLs (Alcon), WW-packaged 3-piece AcrySof IOLs, and Sensar® IOLs (Allergan Medical Optics) were analyzed in vitro for 5 consecutive days. Ten IOLs of each type were inserted into viewing chambers filled with balanced salt solution, maintained at 37°C, and evaluated every 24 hours at 37°C and then, after a 2-hour cooling, at room temperature. The IOLs were examined by slitlamp to quantify glistenings and by digital photography to determine glistening size. Results: The glistening quantity was minimal and did not differ among IOL types at 37°C. The glistenings were smallest in the 1-piece AcrySof IOLs ( P < .001): 6.3 μm versus 11.5 μm in the Sensar and 13.4 μm in the 3-piece AcrySof. Upon cooling, the glistening quantity increased dramatically in the 1-piece AcrySof IOLs ( P < .008) and was the highest among the IOL types at room temperature ( P < .001). The mean glistening size was 7.7 μm. The 3-piece AcrySof IOLs showed a significant decrease in slitlamp-countable glistenings but acquired a dense haze seen as minute glistenings (4.0 μm) at ×80 magnification. The glistening quantity in the Sensar IOLs was fairly stable upon cooling; a statistical increase was seen on the last day ( P = .007). Cooling nearly doubled the size of the Sensar glistenings, which were the largest at room temperature, 21.7 μm ( P < .001). Conclusions: Glistening quantity varied among hydrophobic acrylic IOLs and was temperature dependent. Sensar IOLs were more stable than the 2 other IOL types. The glistening phenomenon must be studied further to eliminate the problem.

Lens epithelial cell outgrowth on 3 types of intraocular lenses

Purpose To compare the outgrowth of lens epithelial cells (LECs) on 3 types of intraocular lenses (IOLs) to determine the influence of lens material and lens design (optic edge) on this phenomenon. Setting Department of Ophthalmology, University of Vienna, Medical School, Vienna, Austria. Method Ninety eyes scheduled for cataract surgery were included in a prospective comparative study. A standardized surgical procedure was performed by 1 experienced surgeon. Patients received 1 of 3 types of posterior chamber IOLs of similar design with a 6.0 mm optic and poly(methyl methacrylate) haptic: AcrySof® (Alcon), HydroView™ (Bausch & Lomb), or Sensar™ (Allergan). Each IOL type was implanted in 30 eyes. Postoperative biomicroscopic examinations were performed 1, 3, 7, 30, 90, and 180 days and 1 year after surgery. Lens epithelial cells in each quadrant of the anterior lens surface were subjectively graded. The product with the highest density and the number of quadrants with this density were used to measure LEC outgrowth. Results Statistically significant differences ( P < .05) were seen between the hydrophilic IOL and the 2 hydrophobic lenses from day 30 until the final examination. The HydroView lens had a higher number of LECs on its anterior surface than the AcrySof or Sensar IOL. There were no statistically significant differences between the 2 acrylic IOLs at any measurement. Conclusion The findings suggest that lens surface properties have a greater influence on LEC outgrowth than lens design (ie, sharp optic edge).