Transcript PPT - Wiols.com

Outcomes after WIOL – CF accommodative
intraocular lens implantation
Ioannis G. Pallikaris MD, PhD, Dimitra M. Portaliou MD
Institute of Vision and Optics
University of Crete School of Medicine
Heraklion, Crete Greece
WIOL – CF Accommodative IOL
Lens characteristics were selected to
secure adequate contact with the
biggest part of the posterior capsule
but not alteration of the capsule
shape.
WIOL – CF geometry
Large continuous aspheric optics
assures lens centricity and reduces
reflections and halos that can cause
night vision problems.
The lens design is intended to provide
up to 2.0 diopters
of“pheudoaccommodation” capability
facilitating near vision.
WIOL – CF Material features and benefits
The WIOL - CF accommodative design is based on the
biomimetic principle – imitation of the crystalline lens.
Large diameter, no haptics, hydro gel material used, high
water content (41%) and lens geometry simulate some of the
key properties of the crystalline lens itself.
Advantages: No decentration problems (lens is self –
centered after impantation), no haptics complications
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
WIOL – CF can be
inserted through a
2.8mm incision.
Once the lens is
inserted, it unfolds
inside the capsule and
gradually hydrates by
the fluid present in the
eye.
Complete hydration is
succeeded within the
first 48 hours
and full equilibrium
with the eye fluids is
achieved.
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 .
Mean follow up 11,44 ± 2,46 months
(range from 9 to 17 months)
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
Safety
No eye has lost lines of CDVA at 1 year postoperatively
88% of patients gained ≥ 1 lines of CDVA
PREOP
Decimal CDVA
Mean±SD
[Range]
Decimal UDVA
Mean±SD
[Range]
0.61 ± 0.19
0.31±0.17
[0.2 to 1]
[CF to 0.7]
POSTOP
Decimal CDVA
Mean±SD
[Range]
Decimal UDVA
Mean±SD
[Range]
0.82±0.13
0.74±019
[0.4 to 1]
[0.2 to 1]
Stability
0.00 LogMar equals at 1.00 decimal Visual Acuity
Uncorrected Near Visual Acuity
72% of our patients had J2 or better, at one year postoperatively, 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 one year postoperatively, 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
Higher Order Aberrations
Contrast Sensitivity at 1 year postoperatively
Innovation
Peripheral capsule reconstruction ring and
accommodative IOL (WIOL - CF) implantation
Intraoperative photos
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
Thank you for your attention
Cornea and corneal
refractive surgery module
February 6 – 10, 2012
Lugano, Switzerland
www.esaso.ch