Enhancement surgery with a two-component, adjustable intraocular lens system: initial results

Session Details

Session Title: Presbyopia Management

Session Date/Time: Sunday 08/10/2017 | 16:30-18:00

Paper Time: 17:15

Venue: Room 2.1

First Author: : H.Uy PHILIPPINES

Co Author(s): :    H. Ginis                    

Abstract Details

Purpose:

Accurate refractive outcomes are a major goal of premium IOL cataract surgery. Despite advances in biometry technology, refractive surprises still occur. One solution for correcting postoperative errors of refraction (EOR) is the use of an adjustable intraocular lenses (AIOL) with 2 refractive components: a front lens optic and a base lens optic. We investigated the efficacy and safety of enhancement surgery using a two-component AIOL (Precisight®, InfiniteVision Optics, Strasbourg, France) for correcting EOR after cataract surgery.

Setting:

A clinical trial of the Precisight® lens system to establish in an “A” constant was started in 2016 (ClinicalTrials.gov ID: NCT02970487, Peregrine Eye and Laser Institute, Makati, Philippines). In addition to establishing an “A” constant, the ability to perform enhancement surgery to fine tune initial refractive results was also evaluated.

Methods:

Of 49 eyes implanted with the AIOL, 15 eyes had postoperative EOR ≥ 1.0D sphere and < -1.0 cylinder at 3 months after cataract surgery and underwent enhancement surgery to correct residual refractive error. In the enhancement procedure the primary front optic was removed from the base optic and replaced with a new front lens optic with the corrected dioptric power-- a procedure which takes less than five minutes to complete. The main outcome measure was the change in the amount of EOR after enhancement at the 3 month postoperative visit.

Results:

At the time of abstract submission 6 patients reached the 3 months post-enhancement visit. The mean ± SD absolute spherical equivalent (SE) was 1.5 ± 0.4 (range, 1.1 to 2.0) pre-enhancement and 0.2 ± 0.1 (range, 0.0 to 0.4) post-enhancement. The mean change of absolute SE was 1.3 ± 0.3 (range, 1.0 to 1.8). After enhancement, 100% had an improved SE and a minimum gain of 2 lines in Uncorrected Visual Acuity (UCVA). Median UCVA was 0.4 logMAR (range, 0.1 to 0.6) before enhancement and 0.0 logMAR (range, -0.2 to 0.1) after enhancement. No visually significant adverse events were observed.

Conclusions:

The two-component AIOL system can easily, accurately and safely correct postoperative EOR by exchanging the primary front lens optic for a new front lens optic with the corrected dioptric power. This adjustable lens system provides a reliable, reproducible, safe and time-independent method of achieving and adjusting desirable refractive outcomes after cataract surgery. Future iterations of this AIOL will allow for adjustments after toric and multifocal intraocular lens placement.

Financial Disclosure:

research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented