Preliminary results after WIOL – CF accommodative intraocular lens implantation

1. Preliminary results after WIOL – CF accommodative intraocular lens implantation Institute of Vision and Optics University of Crete School of Medicine Heraklion, Crete Greece Ioannis G. Pallikaris, Dimitra M. Portaliou, George D. Kymionis

2. WIOL – CF Basic properties • The WIOL - CF accommodative design is based on the biomimetic principle. • The hydro gel material used and the lens geometry simulate some of the key properties of the crystalline lens itself. • The WIOL – CF can be actually considered more as a natural product and not a typical engineered one.

3. WIOL – CF Basic properties • Lens characteristics were selected to secure adequate contact with the biggest part of the posterior capsule but not alteration of the capsule shape. • 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 2.5 diopters of“pheudoaccommodation” capability facilitating near vision. WIOL – CF geometry

4. 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.

5. Materials and Methods • 15 patients (30 eyes) • Mean age: 67, 4 ± 7, 13 years (range from 56 to 81 years) • 6 male, 9 female • All patients underwent routine cataract surgery and WIOL – CF accommodative intraocular lens implantation . • Mean follow up 5,86 ± 3,24 months • (range from 2 to 12 months)

6. 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

7. Video

8. Results • Uncorrected Distance Visual Acuity (UDVA) improved from 0,45 ± 0,21 (range from 0,1 to 0,9) preoperatively to 0,66 ± 0,13 (range from 0,4 to 1) at the last follow up (Figure 3) • Corrected Distance Visual Acuity (CDVA) improved from 0,57 ± 0,19 (range from 0,2 to 1) preoperatively to 0,75 ± 0,11 (range from 0,6 to 1) at the last follow up (Figure 4) Figure 3 Figure 4

9. Safety No eye has lost lines of CDVA 71% of eyes has gained lines of CDVA

10. Results 64% of our patients had J1 , J1 – J2, at the last follow up, measured with Birkhauser reading charts at a distance of 35cm under photopic conditions.

11. Accommodation assessing with the iTrace Far Difference Map Near

12. Accommodation assessing with the Wasca FAR NEAR

13. 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

14. Thank you for your attention