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Outcomes after WIOL – CF accommodative intraocular lens implantation

Outcomes after WIOL – CF accommodative intraocular lens implantation. I nstitute of V ision and O ptics University of Crete School of Medicine Heraklion, Crete Greece. Ioannis G. Pallikaris MD, PhD, Dimitra M. Portaliou MD. WIOL – CF Accommodative IOL.

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Outcomes after WIOL – CF accommodative intraocular lens implantation

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  1. Outcomes after WIOL – CF accommodative intraocular lens implantation Institute of Vision and Optics University of Crete School of Medicine Heraklion, Crete Greece Ioannis G. Pallikaris MD, PhD, Dimitra M. Portaliou MD

  2. 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. • 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 geometry

  3. 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

  4. 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

  5. F1 F2 WIOL- CF change of focus via lens deformation due to the action of natural focusing apparatus (cilliary muscle and zonules):

  6. 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.

  7. 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)

  8. Exclusion Criteria • Astigmatism higher than 1.25 diopters • Pre-existing ocular historycorneal 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

  9. Implantation

  10. Safety No eye has lost lines of CDVA at 1 year postoperatively 88% of patients gained ≥ 1 lines of CDVA

  11. PREOP POSTOP

  12. Stability 0.00LogMar equals at 1.00 decimal Visual Acuity

  13. 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.

  14. 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.

  15. Natural Accommodation NEAR DIF.MAP FAR

  16. Pseudoaccommodation assessed with the iTrace NEAR Range 9.35D Max -3.53D FAR Mean diff. -1.18D Max diff -7.20D

  17. Pseudoaccommodation assessed with the iTrace NEAR Range 6.55D Max -4.84D Mean diff. -1.00D Max diff -3.66D FAR

  18. Higher Order Aberrations

  19. Contrast Sensitivity at 1 year postoperatively

  20. InnovationPeripheral capsule reconstruction ring and accommodative IOL (WIOL - CF) implantationIntraoperative photos

  21. 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

  22. Thank you for your attention

  23. Cornea and corneal refractive surgery moduleFebruary 6 – 10, 2012 Lugano, Switzerland www.esaso.ch

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