Transcript PPT - Wiols.com

Outcomes after WIOL – CF accommodative
intraocular lens implantation
Ioannis G. Pallikaris MD, PhD, Dimitra M. Portaliou MD, Sophia I.
Panagopoulou PhD
Institute of Vision and Optics
University of Crete School of Medicine
Heraklion, Crete Greece
Financial Disclosure
None of the authors has financial interests or
relationships to disclose.
WIOL – CF: Polyfocal hyperbolic optics
Refractive power is maximum in the
centre and gradually decreases in the
periphery
WIOL – CF Features and benefits
Continuous sharp edge
Smooth gradual transition between central and peripheral optics
Aspheric hyperboloid optics
Full disc configuration
Less optical complications, optimum vision quality
WIOL- CF change of focus via
lens deformation due to the action of natural focusing
apparatus (cilliary muscle and zonules):
F1
F2
Clinical experience so far
11 key scientific publications and presentations
Results for 476 WIOL-CF eyes recorded in clinical trials adding to
more than 500 eye-years of clinical-trial reported experience
Predominantly investigator driven studies and publications
WIOL-CF consistently shows accommodation range of more than 2D,
that corresponds to the accomodation range of natural crystalline lens in
42-50 years of age. The range is stable over the long-term (up to 9 years)
Study / Observation
Number of Eyes
Accommodation Range
Time of Evaluation
Pasta J 2003
79
2D
3 years
(67 eyes, 9 years
follow-up)
Pasta J et al 2006
26
2.2 D
(young active: 2-3 D)
over 12 m
Nylander A et al
2006
51
˃ 2.25 D
Up to 24 months
Pallikaris IG 2011
50
2D
24 months
Materials and Methods
25 patients (50 eyes)
Mean age: 65, 3 ± 8,4 years
(range from 53to 83 years)
12 male, 13 female
All patients underwent routine
cataract surgery and WIOL – CF
accommodative intraocular lens
implantation .
Exclusion 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 surgery
Retinal conditions or predisposition to retinal conditions, previous history of/or
predisposition to: retinal detachment or proliferative diabetic retinopathy.
Amblyopia
Clinically severe corneal dystrophy (e.g., Fuchs')
Extremely shallow anterior chamber
Recurrent anterior or posterior segment inflammation of unknown etiology, or any
disease producing an inflammatory reaction in the eye (e.g. iritis or uveitis).
Aniridia
Optic nerve atrophy
Trauma
Implantation
PREOP
LogMAR CDVA
Mean±SD
[Range]
LogMARUDVA
Mean±SD
[Range]
0.25 ± 0.16
0.84±0.62
[0.0 to 0.8]
[CF to 0.24]
Last Postoperative
Days/ Months
Mean±SD [Range]
649.32±378.18 [1404 to 98]
21.64±12.61 [46.8 to 3.27]
Last POSTOP
LogMARCDVA
Mean±SD
[Range]
LogMAR UDVA
Mean±SD
[Range]
0.08±0.07
0.16±0.13
[0.0 to 0.22]
[0.0 to 0.54]
Safety
No eye has lost lines of CDVA
88% of patients gained ≥ 1 lines of CDVA
Stability
1.30
1.20
1.10
Visual Accuity (LogMar)
1.00
0.90
0.80
0.83
0.70
0.60
CDVA
0.50
UDVA
0.40
0.30
0.25
0.18
0.17
0.18
0.14
0.20
0.16
0.10
0.11
0.00
0.10
0.09
0.08
0.09
-0.10
PreOp
1 month
3 months
6 months
12 months
Last PostOp
Time After Surgery
0.00 LogMar equals at 1.00 decimal Visual Acuity
Uncorrected 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.
Uncorrected 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.
Natural Accommodation
D
I
F
.
M
A
P
N
E
A
R
F
A
R
Pseudoaccommodation assessed with the iTrace
NEAR
Range
9.35D
Max
-3.53D
FAR
Mean diff.
-1.18D
Max diff
-7.20D
Pseudoaccommodation assessed with the iTrace
NEAR
Range
6.55D
Max
-4.84D
Max diff
-3.66D
Mean diff.
-1.00D
FAR
Slit Lamp photos of patients
AS – OCT image (Visante)
Conclusions
WIOL – 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