1. Studený P., Dědková B., Farkaš A., Vokrojová M., Siveková D., Břešťák M. Oční klinika FNKV a 3 LF UK Praha Oční oddělení, Karlovarská krajská nemocnice a.s. Centrum Fetální medicíny Praha Accommodation measurement in eyes implanted with Tek-Clear Accommodative Intraocular Lens Tek-Clear Accommodative IOL is manufactured by: TEKIA, INC. www.tekia.com

2. Multifocal IOL Refractive/diffractive Accommodating IOL Predictability: far vision ++ intermediate vision + -+ near vision + + - Disphotopic phenomena +- Contrast sensitivity -0 Stability of refraction + + - Ways to restore accommodative ability after cataract surgery

3.  Disc-shaped; excellent stability and centration in capsular bag  5.5 mm optic, 10.4 or 10.2 mm haptic  Biconvex shape  Hydrophilic acrylic  A-constant 118.0  Thin junctions between optic and haptic part ; lens movement optimization during accommodation (pseudophakic accommodation)  Square-edge design to minimize PCO Tek-Clear Accommodative IOL

4.  Number of patients: n=18 (32 eyes)  Average age of patients: 60.6 (28-81)  Follow up time: 3 months at least  Preoperative UCVA: 0.28 (0.05- 0.7)  Preoperative BCVA: 0.65 (0.05-1.0)  Preoperative refraction (SE): 2.125 (0-6)  Cataract  Examination objectives: UCVA, BCVA, accommodative amplitude Patients, materials and methods

5.  1 phaco surgeon  Standard cataract surgery, CCI 2.2mm, incision u.12, Infinity vision system, bimanual I/A, PCIOL implantation without OVD Patients, materials and methods

7. IOL movement in eye

8. Ultrasound system Vivid7Pro, Probe L12M

9. Ultrasound examination

10.  Push-up test  Defocus  Plusoptix Eye accommodation examination

11.  Subjective method  Optimal correction for long distance  Text is moved towards the patient – he/she notifies when the text becomes blurred Push-up test – results

12.  After 7 days 3.92 D (1-5)  After 1 month 3.52 D (1-5)  After 3 months 4.17 D (1-5) Push-up test – results

14.  Subjective method  Optimal correction for long distance  Patient watches optotypes placed 5m in front of him  Minus lens correction is progressively increased until the image become blurred Defocus method

15.  After 7 days – 0.79D (- 0.5D -1.25D)  After 1 month – 0.85D ( -0.5D – 1.25D)  After 3 months – 0.87D ( -0.5D – 1.5D) Defocus method – results

16.  Objective method  Binocular auto-refractometer is placed 1 meter in front of the patient  Fixation target is moved towards the patient  Changes in eye refraction are recorded – refraction difference between short and long distance Plusoptix

17.  After 7 days – 1.92D ( 0.88 – 3.04)  After 1 month – 2.16D ( 0.89 – 4.18)  After 3 months – 2.2D (1.0 – 3.6) Plusoptix – results

19.  Excellent accommodation ability of Tek-clear IOL was demonstrated by means of subjective and objective examination of accommodation amplitude at 3 months follow up.  Anterior optic vault during accommodation was captured using high-frequency ultrasound – this effect explains increase in optical power of lens Summary

20.  Longer follow up time is needed  More patients Summary

21. Thank you for your attention