Intraokularlinsen für die mikroinzisionale Kataraktchirurgie

Recent Advances of Intraocular Lens Materials and Surface Modification in Cataract Surgery

Advances in cataract surgery have increased the demand for intraocular lens (IOL) materials. At present, the progress of IOL materials mainly contains further improving biocompatibility, providing better visual quality and adjustable ability, reducing surgical incision, as well as dealing with complications such as posterior capsular opacification (PCO) and ophthalmitis. The purpose of this review is to describe the research progress of relevant IOL materials classified according to different clinical purposes. The innovation of IOL materials is often based on the common IOL materials on the market, such as silicon and acrylate. Special properties and functions are obtained by adding extra polymers or surface modification. Most of these studies have not yet been commercialized, which requires a large number of clinical trials. But they provide valuable thoughts for the optimization of the IOL function.

Scanning electron microscopy study of different one-piece foldable acrylic intraocular lenses after injection through microincisional cataract surgery cartridges

PURPOSE

To evaluate possible surface alterations of different models of one-piece foldable acrylic intraocular lenses (IOLs) after folding and ejecting process through 2.2-mm microincisional cataract surgery (MICS) cartridges.

METHODS

In this experimental laboratory study, the following IOLs were studied: Johnson&Johnson PCB00, HOYA iSert 251, Alcon AcrySof IQ SN60WF, Bausch&Lomb enVISTA MX-60. A total of 80 IOLs were analyzed. Twenty intraocular lenses of each type were studied: ten with a power of + 21 D ± 1 and ten with a power of + 28 D ± 1. IOLs were injected through a dedicated 2.2-mm MICS cartridge into a 50-mL vial containing 10 mL of deionized water. After rinsing and metallization process, scanning electron microscopy images were acquired.

RESULTS

All IOLs presented high-quality construction biomaterials. Some IOLs showed superficial scratches and tears on the optic surface, mainly positioned according to the direction of the stress induced by the folding process. In other cases, small superficial tears were seen in a more peripheral position.

CONCLUSIONS

All lenses showed excellent surface quality. After folding and injection process some superficial scratches and tears of the IOL optic were detected in some models. Further studies are needed to assess the possible effects of those superficial damages on the optical quality of the IOLs.

Posterior capsular opacification and Nd:YAG capsulotomy rates with the iMics Y-60H and Micro AY intra-ocular lenses: 3-year results of a randomized clinical trial

PURPOSE

To compare the incidence and intensity of posterior capsular opacification (PCO) and neodymium:yttrium-aluminium-garnet (Nd:YAG) capsulotomy rates between two microincision intra-ocular lenses (IOLs) 3 years after surgery.

METHODS

Sixty-five patients randomly received a Y-60H IOL (HOYA Surgical Optics, Singapore) in one eye and a Micro AY IOL (PhysIOL, Liège, Belgium) in the contralateral eye during same-day bilateral cataract surgery. Eyes were examined 1 week, 20 months and 3 years after surgery. The amount of PCO (score: 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software (aqua). Additionally, the Nd:YAG capsulotomy rate was noted.

RESULTS

Three years postoperatively, the objective PCO score of Y-60H IOLs was 1.9 ± 1.7 compared to PCO score of 1.7 ± 2.2 for the Micro AY IOLs (p = 0.66). Thirty-four percentage of the Y-60H eyes had undergone Nd:YAG capsulotomy, compared to 49% of the Micro AY eyes (p = 0.04). Significantly, more capsular folds were observed in the Y-60H IOL group (p = 0.001). There was no significant difference in best-corrected visual acuity, rhexis/IOL overlap and anterior capsule opacification 3 years after surgery.

CONCLUSION

Both microincision IOLs showed high YAG rates and comparable PCO scores 3 years after surgery. In the light of this unsatisfying PCO performance, the advantage of the present microincision IOLs over conventional IOLs must be questioned.