1. 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

2. 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

3. 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

4. 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

5. 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

6. 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.

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

8. 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

9. 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

10. 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

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

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