Outcomes after WIOL – CF accommodative intraocular lens implantation

1. Outcomes after WIOL – CF accommodative intraocular lens implantation Institute of Vision and Optics University of Crete School of Medicine Heraklion, Crete Greece Ioannis G. Pallikaris MD, PhD, Dimitra M. Portaliou MD, Sophia I. Panagopoulou PhD

2. Financial Disclosure None of the authors has financial interests or relationships to disclose.

3. WIOL – CF: Polyfocal hyperbolic optics Refractive power is maximum in the centre and gradually decreases in the periphery

4. WIOL – CF Features and benefits • Continuous sharp edge • Smooth gradual transition between central and peripheral optics • Aspheric hyperboloid optics • Full disc configuration Less optical complications, optimum vision quality

5. WIOL- CF change of focus via lens deformation due to the action of natural focusing apparatus (cilliary muscle and zonules): F1 F2

6. Clinical experience so far • 11 key scientific publications and presentations • Results for 476 WIOL-CF eyes recorded in clinical trials adding to more than 500 eye-years of clinical-trial reported experience • Predominantly investigator driven studies and publications

7. WIOL-CF consistently shows accommodation range of more than 2D, that corresponds to the accomodation range of natural crystalline lens in 42-50 years of age. The range is stable over the long-term (up to 9 years)

8. Materials and Methods • 25 patients (50 eyes) • Mean age: 65, 3 ± 8,4 years (range from 53to 83 years) • 12 male, 13 female • All patients underwent routine cataract surgery and WIOL – CF accommodative intraocular lens implantation .

9. Exclusion Criteria • Astigmatism higher than 1.25 diopters • Pre-existing ocular historycorneal endothelial disease, abnormal cornea, macular degeneration, retinal degeneration, glaucoma, and chronic drug miosis. • Previous refractive surgery • Retinal conditions or predisposition to retinal conditions, previous history of/or predisposition to: retinal detachment or proliferative diabetic retinopathy. • Amblyopia • Clinically severe corneal dystrophy (e.g., Fuchs') • Extremely shallow anterior chamber • Recurrent anterior or posterior segment inflammation of unknown etiology, or any disease producing an inflammatory reaction in the eye (e.g. iritis or uveitis). • Aniridia • Optic nerve atrophy • Trauma

10. Implantation

11. PREOP Last POSTOP

12. Safety No eye has lost lines of CDVA 88% of patients gained ≥ 1 lines of CDVA

13. Stability 0.00LogMar equals at 1.00 decimal Visual Acuity

14. Uncorrected Near Visual Acuity 72% of our patients had J2 or better, at the last follow – up examination, measured with Birkhauser reading charts at a distance of 33cm under photopic conditions.

15. Uncorrected Intermediate Visual Acuity 72% of our patients had J2 or better, at the last follow – up examination, measured with Birkhauser reading charts at a distance of 66cm under photopic conditions.

16. Natural Accommodation NEAR DIF.MAP FAR

17. Pseudoaccommodation assessed with the iTrace NEAR Range 9.35D Max -3.53D FAR Mean diff. -1.18D Max diff -7.20D

18. Pseudoaccommodation assessed with the iTrace NEAR Range 6.55D Max -4.84D Mean diff. -1.00D Max diff -3.66D FAR

19. Slit Lamp photos of patients

20. AS – OCT image (Visante)

21. Conclusions • WIOL – CF can be considered a very promising alternative solution for patients that lead an active life and require good vision near, intermediate and far. In our patient series all patients obtained some level of accommodation which remained stable throughout the follow – up period. • No complications occurred intra or postoperatively. • Larger series of patients and longer follow-up is necessary in order to confirm the encouraging results