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Outcomes in First 50 Cases Implanted With IOL Using Hydrophobic Material and 4-Point Platform ASCRS SAN DIEGO 2011 PowerPoint Presentation
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Outcomes in First 50 Cases Implanted With IOL Using Hydrophobic Material and 4-Point Platform ASCRS SAN DIEGO 2011. Dr Christophe Chassain MD, Clinique Beau-Soleil, Montpellier, France

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slide1

Outcomes in First 50 Cases ImplantedWith IOL UsingHydrophobicMaterialand 4-Point PlatformASCRS SAN DIEGO2011

Dr Christophe Chassain MD, Clinique Beau-Soleil, Montpellier, France

Financial disclosure: The author of this e-poster has received travel expense reimbursement from Physiol Company

material and methods
Material and methods
  • The same IOL design in hydrophilic and hydrophobicmaterial (PodAY, Physiol, Belgium).
  • Normal clinicalfollow-up (visualacuity, slitlampexamination, IOP…)
  • Retrospective photo analysis to determine the IOL center at 3 months and the IOL rotation between 0 and 3 months.
slide3

PodAY  «PHILE » 26% hydrophilic monobloc

True 360° square edge 6 mm aspheric yellow optic

2 open symetrical « V » shape haptics with a 5° angulation

4 - point IOL design

11,17 mm overall diameter

PodAY « PHOBE »

Hydrophobic monobloc

True 360° square edge 6 mm aspheric yellow optic

2 open symetrical « V » shape haptics with a 5° angulation

4 - point IOL design

11,40 mm overall diameter

slide4

PHILE

PHOBE

Clinical study

117 eyes from 91 patients

87 females and 30 males

Mean age: 72 (45/88)

55 OD and 66 OS

No exclusion criteria

Phacoemulsification

Topical anesthesia

2.4 mm incision (Miniset injector)

Mean IOL : 20.04±4.56 D (10 to 29 D)

Visual acuity and biomicroscope examination ( 1 week, 3 weeks, 3 months, 1 year)

Angle and center stability calculated by triangulation and elliptical fit for 50 eyes

at 1 year

94 eyes from 77 patients

56 females and 38 males

Mean age: 75 (48/94)

50 OD and 44 OS

No exclusion criteria

Phacoemulsification

Topical anesthesia

2.2 mm incision (MDJ injector)

Mean IOL : 21.7±2.11 D (16 to 25D)

Visual acuity and biomicroscope examination ( 1 week, 3 weeks, 3 months)

Angle and center stability calculated by triangulation and elliptical fit for 50 eyes at 3 months

results surgery
Results: Surgery

PHILE

PHOBE

Injection through 2.4 incision

No IOL was damaged

Immediate centration of the lens

Easy clockwise and anti clock wise rotation in all capsular bags

8 IOLs from a total of 117 encountered a slight spontaneous rotation during IA.

Injection through 2.2 mm incision

No IOL was damaged, posterior haptics sticked for a few seconds in some eyes

Immediate centration of the lens

Easy clockwise and anti clock wise rotation in all capsular bags

1 IOL from a total of 94 encountered a slight spontaneous rotation during IA.

results visual acuity
Results: Visual acuity

PHILE

PHOBE

Myopic spherical equivalent due to monovision technique used in most patients

results centration
Results: centration

0.19±0.08 mm 0.23±0.12 mm

PHILE

PHOBE

discussion
Discussion

Kwartz J, Edwards K. Evaluation of the long-term rotational stability of single-piece, acrylic intraocular lenses. Br J Ophthalmol. 2010 Aug;94(8):1003-6.

Tsinopoulos IT, Tsaousis KT, Tsakpinis D, Ziakas NG, Dimitrakos SA. Acrylic toric intraocular lens implantation: a single center experience concerning clinical outcomes and postoperative rotation. Clin Ophthalmol. 2010 Mar 24;4:137-42.

Chang DF. Comparative rotational stability of single-piece open-loop acrylic and plate-haptic silicone toric intraocular lenses. J Cataract Refract Surg. 2008 Nov;34(11):1842-7.

Weinand F, Jung A, Stein A, Pfützner A, Becker R, Pavlovic S. Rotational stability of a single-piece hydrophobic acrylic intraocular lens: new method for high-precision rotation control.J Cataract Refract Surg. 2007 May;33(5):800-3.

Mendicute J, Irigoyen C, Aramberri J, Ondarra A, Montés-Micó R. Foldable toric intraocular lens for astigmatism correction in cataract patients. J Cataract Refract Surg. 2008 Apr;34(4):601-7.

Koshy JJ, Nishi Y, Hirnschall N, et al. « Rotational stability of a single-piece toric acrylic intraocular lens ». J Cataract Refract Surg. 2010 Oct;36:1665-1670

discussion1
Discussion
  • The dispersion around the mean centration value is in the order of magnitude of uncertainty shown by Womffsohn
  • The new IOL design has achieved an as good centration as other profiles that are between 0.26 and 0.42 mm (Verbruggen).
  • Its diameter and its haptics shape were designed to fit any capsular bag with no anterior or posterior displacement of the optical part.
  • This large IOL unfolds and takes place in the bag in a physiological position with respect to the pupil.
  • It does not rotate after surgery.

Wolffsohn JS, Buckhurst PJ. Objective analysis of toric intraocular lens rotation and centration.J Cataract Refract Surg. 2010 May;36(5):778-82.

Verbruggen KH, Rozema JJ, Gobin L, Coeckelbergh T, De Groot V, Tassignon MJ. Intraocular lens centration and visual outcomes after bag-in-the-lens implantation.J Cataract Refract Surg. 2007 Jul;33(7):1267-72.

conclusion
CONCLUSION

PHILE

PHOBE

Both IOLs have an excellent refractive, centration and rotation stability.

The new hydrophobic IOL is injected through a smaller incision than the hydrophilic IOL, and the quasi absence of spontaneous rotation during surgery makes that IOL more appropriate for an astigmatism pseudophakic correction.

The new hydrophobic IOL is likely to be the best choice for a premium IOL if the clinical outcomes are confirmed with time.