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Presentation transcript:

Authors have no financial interests Results of Hydrophobic Acrylic IOL Insertion through Corneal Microincisions Smaller than 2.0 mm Tomoichiro Ogawa, Takuya Shiba Hiroshi Tsuneoka Jikei University School of Medicine, Tokyo, Japan Authors have no financial interests

AF-1 iMics1（HOYA） Hydrophobic acrylic intraocular lens (IOL) Implanted through corneal microincisions iMics1 Y-60H 6mm HOYA社製、アクリル眼内レンズAF-1 iMicsは光学径6mm

Purpose AF-1 iMics1（HOYA） Injector : ISH004(HOYA) Cartridge : Type-N18 （HOYA） Preferred incision size: Cornea, 2.0 mm; Sclera cornea, 1.8 mm Purpose N18は従来のカートリッジと比べ外径が小さく、メーカー推奨切開創サイズは・・・・ To evaluate the safety and efficacy of cataract surgery with implantation of the AF-1 iMics1 IOL through a corneal microincision

Subjects and Method May - August 2009 Jikei University Hospital Procedures: 69 eyes 1.7-mm （inner scale） corneal incision: 47 eyes 2.0-mm （inner scale） corneal incision: 22 eyes Operative method 1.4-mm temporal corneal incision Bimanual phacoemulsification Incisions enlarged to 1.7 or 2.0 mm Implant AF-1 iMics1 1.9mm・2.2mm創口拡大用ナイフ　　無縫合

Variables examined Incision size（before and after IOL implantation） Tsuneoka microincision gauge （ASICO） Increased width of corneal incision after IOL implantation Surgery-induced corneal astigmatism（Cravy method） 1 month postoperatively Operative complications Postoperative complications

Results Wound width Increased wound width ** **2008. Ogawa. ESCRS. ＊ ** 1.7 mm 2.0 mm Increased wound width ＊ P=0.0025 Mann-Whitney U-test **2008. Ogawa. ESCRS.

Surgery- induced corneal astigmatism Results （D） ** ＊NS *Mann-Whitney U-test Surgery- induced corneal astigmatism 1.7mm 2.0mm **2008. Ogawa. ESCRS.

Results 1.7 mm 2.0 mm 0 eye/47 1 eye/22 100% 1.7 mm 2.0 mm 0% 100% Posterior capsule rupture 0 eye/47 1 eye/22 Wound self-healing 100% Operative complications 1.7 mm 2.0 mm IOL decentration 0% Cystic macula edema Wound self-healing 100% Post- operative complications 組織学的な異常がどこまで臨床に関係があるかということ不明臨床上大きな問題が生じていないしかし、常に組織学的な面も意識しながら、今後とも検討していきたい

Insertion of cartridge Discussions Posterior capsule rupture Insertion of cartridge Tip of cartridge Tip of cartridge is too deep in anterior chamber and too close to posterior capsule

Tacking tips of both forward and back haptics AF-1 iMics1 SN60WF Full length is greater Tacking tips of both forward and back haptics Full length of IOL is greater than that of other foldable 1-piece IOLs AF-1 iMics1 is stiffer

Posterior capsule rupture IOL implantation Posterior capsule rupture IOL is released near posterior capsule IOL goes through posterior capsule Posterior capsule ruptures

Conclusion AF-1 iMics1（HOYA） Implanted through corneal incision < 2.0 mm Little surgery-induced astigmatism Wound self-healing Carefully position tip of cartridge