“Accommodating IOL Implantation Experience”

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Presentation transcript:

“Accommodating IOL Implantation Experience” Mauricio Miranda MD, Luis Izquierdo Jr. MD Authors have no financial interest

Purpose To evaluate the accommodative range of the NuLens AIOL in 5 patients and to study its behavior and biomechanics in 5 eyes implanted by one experience surgeon (L. Izquierdo) at Oftalmosalud Eye Institute Lima-Peru.

Material and Methods Material and Methods: 5 eyes of patients range between 27 and 65 years old, 4 women and 1 men, with normal anterior chamber and no corneal pathology who had impaired vision in one eye due to amblyopia (4 high myops and 1 cataract patient).

Material and Methods Pre-surgical examination: Biomicroscopy, IOL master, UBM, Visante-OCT were done to all patients. A perfect 5.5 mm continuous circular capsulorrhexis normal Phacoemulsification was performed; the NuLens AIOL was implanted in 2 steps. First the Base of the Lens and secondly, the Haptic of the IOL. An endoscopic revision of the incision of the zonule was examined by Dr. Joshua Ben-nun at the operating room.

Results Pre-Implantation values: sphere (media -5.60), cylinder (media -2.55), axis (media 52.00), LogMar BCVA (media 0.6520) and near VA at 40cm (media 12.25). Post-Implantation values: sphere (media -0.45), cylinder (media -2.50), axis (media 73.80), LogMar BCVA (0.7380) and near VA at 40cm (media 14.50). Accommodative range: 6.00 Diopters. p=0.0000 (See Table).

Results of accomodative range of NULENS (AIOL) Sphere Media +3 5 -4.6500 -3 2.0000 Results of accomodative range of NULENS (AIOL)

Zonule implatation of the haptic of the NULENS AIOL

5.5 mm CCC of the NULENS two pieces AIOL

Conclusions This is a new technology which seems to be an alternative in the future to achieve more accommodative range and therefore a better quality of vision. We are still working in adjusting the power of the AIOL and its size to improve its biomechanics inside of the eye. NuLens demonstrated to have an accommodative range of 6 Diopters in all patients studied so far and a central positioning without damaging any anterior and posterior chamber structures of the eye.

Conclusions We are demonstrating our preliminary results in 5 patients after 15 days average after AIOL implantation. Far VA has demonstrated a significant improvement even though 4 out of the 5 patients with amblyopia were high myopic (N=5). At the moment, near VA has not been determined accurately due to cyclopegic status of the 5 patients.

References Ben-nun, J. MD & Alió, j. MD, PHD. “Overview of the NuLen Accommodating IOL” CATARACT & REFRACTIVE SURGERY TODAY EUROPE JAN/FEB 2008: 20-21 Menapace, R., Findl, O., Kriechbaum K., & Leydolt-Koeppl, Ch. “Accommodating intraocular lenses: a critical review of present and future concepts”. GRAEFE’S ARCH CLIN EXP OPHTHALMOL. 2007. vol 245: 473–489 “NuLens’ real accommodative IOL homes in on billion-dollar presbyopic market” CLINICAS MEDTECH VENTURES. 30 March 2007. Issue No 8 :13 Chang, D. MD.“Mastering Refractive IOLs: The Art and Science” SLACK Incorporated. 2008