Anterior capsulotomy captured (grooved) IOL to prevent negative dysphotopsia (ND)

Session Details

Session Title: Pseudophakic IOLs: Toric II

Session Date/Time: Sunday 11/09/2016 | 16:00-18:00

Paper Time: 17:16

Venue: Auditorium C6

First Author: : S.Masket USA

Co Author(s): :                        

Abstract Details

Purpose:

ND is an enigmatic problem following uncomplicated cataract surgery. Experience indicates that ND occurs with “in the bag” IOLs and is helped if the IOL optic is placed anterior to the capsulorrhexis by reverse (anterior) optic capture or sulcus placement; both have limitations. Conceptually, an IOL would be “bag” placed yet allow a portion to override the capsulotomy. This has been achieved by creating a grooved optic to capture the capsulotomy. An IOL has been fabricated as the Morcher 90S IOL, CE marked, and has been implanted in limited clinical trials. The current investigation reports the outcomes of those trails.

Setting:

Multiple European Eye Departments or Private Practices

Methods:

50 patients for cataract surgery were selected and consented. Femtosecond laser anterior capsulotomy was used in the majority (40 cases) to facilitate capture of the capsulotomy in the optic groove after removal of OVD from the capsule bag. Patients were followed with regard to centration and stability of the optic. Also, a questionnaire was developed to determine the incidence of ND and patient satisfaction with regard to quality of vision.

Results:

All eyes with laser capsulotomy achieved stable optic groove capture and centration. 3 of 10 eyes with manual capsulorrhexis failed to achieve optic capture and the IOLs were placed in the capsule bag. No patient experienced ND or reduced vision quality after surgery. However, 3 cases developed capsule block syndrome early after surgery; two of those experienced iris capture. Although IOL centration and stability were excellent, given capsule block, a modified optic has been fenestrated to allow egress of fluid from the capsule bag. Additional trials with the new optic design are in progress.

Conclusions:

Preliminary results with the Morcher 90S IOL suggest that the optic design prevents ND and that there are no negative consequences with regard to quality of vision. Furthermore capture of the optic by the anterior capsulotomy brings additional advantages in terms of optic centration and stability. However, additional cases are necessary for full proof of concept. Moreover, the modified (fenestrated) optic requires evaluation both with respect to quality of vision and prevention of capsule block. A university based 50 patient clinical trail is planned as are additional study sites in Europe.

Financial Disclosure:

... gains financially from product or procedure presented