Presentation on theme: "Outcomes after WIOL – CF accommodative intraocular lens implantation"— Presentation transcript:
1Outcomes after WIOL – CF accommodative intraocular lens implantation Ioannis G. Pallikaris MD, PhD, Dimitra M. Portaliou MD, Sophia I. Panagopoulou PhDInstitute of Vision and OpticsUniversity of Crete School of MedicineHeraklion, Crete Greece
2Financial DisclosureNone of the authors has financial interests or relationships to disclose.
3WIOL – CF: Polyfocal hyperbolic optics Refractive power is maximum in the centre and gradually decreases in the periphery
4WIOL – CF Features and benefits Continuous sharp edgeSmooth gradual transition between central and peripheral opticsAspheric hyperboloid opticsFull disc configurationLess optical complications, optimum vision quality
5WIOL- CF change of focus via lens deformation due to the action of natural focusing apparatus (cilliary muscle and zonules):F1F2The mechanism for near focus depends on the lens deformation due to the action of natural focusing apparatus (cilliary muscle and zonules). The WIOL-CF curving during the near-focusing (seen in the focusing eye by high-resolution ultrasonic microscopy) leads to an increase in refractive powerof the lens. This refractive power increase assists the near vision (e.g., for reading).
6Clinical experience so far 11 key scientific publications and presentationsResults for 476 WIOL-CF eyes recorded in clinical trials adding to more than 500 eye-years of clinical-trial reported experiencePredominantly investigator driven studies and publications
7(67 eyes, 9 years follow-up) WIOL-CF consistently shows accommodation range of more than 2D, that corresponds to the accomodation range of natural crystalline lens in years of age. The range is stable over the long-term (up to 9 years)Study / ObservationNumber of EyesAccommodation RangeTime of EvaluationPasta J 2003792 D3 years(67 eyes, 9 years follow-up)Pasta J et al 2006262.2 D(young active: 2-3 D)over 12 mNylander A et al 200651˃ 2.25 DUp to 24 monthsPallikaris IG 20115024 months1: Clinical Evaluation Report. J Pasta, Central Military Hospital, Prague, April February 20033: 3rd generation WIOL-CF, group II. J Pasta, J Hubackova, P Stehlicek, VA Stoy, CMH ( ESCRS congress Barcelona 2008); surgeries:11: WIOL-CF study results. IG Pallikaris, Institute of Vision and Optics, University of Crete School of Medicine7: Clinical Experience with the Accommodative WIOL-CF acrylic IOL. A Nylander, A El-Gendy, East Lancashire Hospitals NHS Trust, UK, 2006; (11th Winter Refractive Surgery Meeting Athens); surgeries:13: Pseudoaccommodation of the full optics IOL. J Pasta, VA Stoy, Dept of Ophtalmology, Central Military Hospital (Europian Ophtalmologic Surgery Society Congress Proceeding of the XXII Congress of the ESCRS Munich 2003); surgeries: 1993 – 1994 (WIOL-C) – 2003 (WIOL-CF, 2nd generation); over 9 years follow-up
8Materials and Methods 25 patients (50 eyes) Mean age: 65, 3 ± 8,4 years (range from 53to 83 years)12 male, 13 femaleAll patients underwent routine cataract surgery and WIOL – CF accommodative intraocular lens implantation .
9Exclusion Criteria Astigmatism higher than 1.25 diopters Pre-existing ocular history corneal endothelial disease, abnormal cornea, macular degeneration, retinal degeneration, glaucoma, and chronic drug miosis.Previous refractive surgeryRetinal conditions or predisposition to retinal conditions, previous history of/or predisposition to: retinal detachment or proliferative diabetic retinopathy.AmblyopiaClinically severe corneal dystrophy (e.g., Fuchs')Extremely shallow anterior chamberRecurrent anterior or posterior segment inflammation of unknown etiology, or any disease producing an inflammatory reaction in the eye (e.g. iritis or uveitis).AniridiaOptic nerve atrophyTrauma
11PREOP Last POSTOP LogMAR CDVA Mean±SD [Range] LogMARUDVA Mean±SD Last PostoperativeDays/ MonthsMean±SD [Range]649.32± [1404 to 98]21.64± [46.8 to 3.27]LogMAR CDVA Mean±SD[Range]LogMARUDVA Mean±SD0.25 ± 0.160.84±0.62[0.0 to 0.8][CF to 0.24]Last POSTOPLogMARCDVA Mean±SD[Range]LogMAR UDVA Mean±SD0.08±0.070.16±0.13[0.0 to 0.22][0.0 to 0.54]
12Safety No eye has lost lines of CDVA 88% of patients gained ≥ 1 lines of CDVA
130.00 LogMar equals at 1.00 decimal Visual Acuity Stability0.00 LogMar equals at 1.00 decimal Visual Acuity
14Uncorrected Near Visual Acuity 72% of our patients had J2 or better, at the last follow – up examination, measured with Birkhauser reading charts at a distance of 33cm under photopic conditions.
15Uncorrected Intermediate Visual Acuity 72% of our patients had J2 or better, at the last follow – up examination, measured with Birkhauser reading charts at a distance of 66cm under photopic conditions.
21ConclusionsWIOL – CF can be considered a very promising alternative solution for patients that lead an active life and require good vision near, intermediate and far. In our patient series all patients obtained some level of accommodation which remained stable throughout the follow – up period.No complications occurred intra or postoperatively.Larger series of patients and longer follow-up is necessary in order to confirm the encouraging results