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Effect of two different haptics to centering of intraocular lens

Effect of two different haptics to centering of intraocular lens. Mayumi Nagata 1,2 , Hiroyuki Matsushima 1 , Wataru Terauchi 1 and Tadashi Senoo 1 1 Department of Ophthalmology, Dokkyo Medical University, Tochigi, JAPAN 2 Saiseikai Utsunomiya Hospital, Tochigi, JAPAN.

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Effect of two different haptics to centering of intraocular lens

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  1. Effect of two different haptics to centering of intraocular lens Mayumi Nagata1,2, Hiroyuki Matsushima1, Wataru Terauchi1 and Tadashi Senoo1 1Department of Ophthalmology, Dokkyo Medical University, Tochigi, JAPAN 2Saiseikai Utsunomiya Hospital, Tochigi, JAPAN The authors have no financial interest in the subject matter of this poster.

  2. PURPOSE • Tilt and decentration of intraocular lens (IOL) influent visual function for resent IOLs. And complete continuous curvilinear capsulorhexis (CCC) is important to prevent tilt and decentration. • In this study, we concentrate the relationship between shapes of haptics and intracapsular stability of the IOL. Eppig T. Effect of decentration and tilt on the image quality of aspheric intraocular lens designs in a model eye. J Cataract Refract Surg. 2009;35:1091-1100

  3. MATERIALS and PATIENTS

  4. Question 1 Do the shape of CCC and IOL Haptic influence on IOL decentration? Analysis 1 Measurement of IOL decentration 1. Images were taken using an EAS-1000 (NIDEK), and patients were divided into the CCC was covered the IOL optic (CC group), and the part of the CCC was outside the IOL optic (NCC group). 2. At 3 months after surgery, the decentration of IOLs were analyzed. The IOL decentration of 2 groups (CC group and NCC group)were compared in 2 different types of IOLs. (Unpaired-t test are used for statistical analysis.)

  5. Results 1 Measurement of IOL decentration Wide Haptics Thin Haptics (n=44) (n=33) (n=30) (n=22) * * *Statistically significance (P<0.05) Answer 1 Decentration was significantly larger in the NCC group than in the CC group. Decentration of “Wide Haptics” was larger than “Thin Haptics” in NCC group.

  6. Question 2 Why do IOLs decentrate in the NCC group? Why decentration of “Wide Haptics” was large? Direction of IOL decentration Analysis 2 Relationships between direction of IOL decentration and area of NCC 90 45 135 B A 180 0 C 225 315 Direction of NCC 1. Direction of IOL Decentration (DID) Center of pupil “A” and center of IOL “B”are decided. Direction from “A” to “B” is defined as “direction of IOL decentration”. 2. Direction of NCC Area (DNCC) Center of NCC area “C” is decided. Direction from “A” to “C” is defined as “direction of NCC”. 3. Correlation between “direction of IOL decentration” and “direction of NCC” were analyzed (Pearson’s correlation coefficient). 270

  7. Results 2 Relationships between direction of IOL decentration and area of NCC Wide Haptics Thin Haptics DID(Degree) DID(Degree) DNCC+180(Degree) DNCC+180(Degree) Correlation coefficient=0.365 Correlation coefficient=0.599 Answer 2 The IOLs move to opposite direction from the NCC area in the “Wide Haptics”; however, there are no correlation in the “Thin Haptics”.

  8. Why the IOLs move to opposite direction from the NCC area? Why the “Wide Haptics” decentrate easily? Wide Haptics + + Soft haptics are not enough to prevent the IOL dislocation. + + CC Adhesion between anterior capsule and IOL is week. NCC Adhesion between anterior capsule and posterior capsule is strong. Thin Haptics ＞ Hard haptics prevent the IOL dislocation. + + Strong adhesion of NCC dislocate IOL toward opposite direction from the NCC area.

  9. Question 3 How to prevent decentration of IOL in case of NCC? Analysis 3 Relationships between IOL decentration and position of IOL haptics • The NCC group was divided into a group which the haptic was fixed to the NCC region (Haptic on NCC group), and a group which the haptic was fixed to the CC region (Haptic on CC group). • 2. Comparison the IOL decentration (the data of 3 months after surgery) of 2 groups were performed. Haptic on CC group Haptic on NCC group Position of Haptics Area of NCC

  10. Results 1 Measurement of IOL decentration Wide Haptics Thin Haptics (n=20) (n=13) (n=9) (n=13) * *Statistically significance (P<0.05) Answer 3 In “Wide Haptics”, the placement of wide haptics to NCC area prevent the IOL decentration.

  11. Why does the placement of haptics on NCC area prevent the IOL decentration only in the “Wide Haptics”? Wide Haptics Thin Haptics The thin haptic is not enough to inhibit adhesion between anterior and posterior capsules. Then the placement of haptics is not effective to prevent the IOL decentration. The wide haptic inhibit adhesion between anterior and posterior capsules. Then the movement of IOL is prevented.

  12. CONCLUSIONS • The IOL decentration was significantly larger in the NCC group than in the CC group. • The IOLs move to opposite direction from the NCC area in the “Wide Haptics”; however, there are no correlation in the “Thin Haptics”. • In “Wide Haptics”, the placement of wide haptics to NCC area prevent the IOL decentration.

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