Accommodating disaccommodating IOL with zonular capture haptics

Session Details

Session Title: Pseudophakic IOLs: Monofocal/Accommodative

Session Date/Time: Tuesday 13/09/2016 | 16:30-18:00

Paper Time: 17:42

Venue: Hall C2

First Author: : P.Beer USA

Co Author(s): :    P. Kaufman   M. Croft   G. Heatley   J. McDonald           

Abstract Details

Purpose:

To measure the dynamic performance of a novel accommodative-disaccommodative IOL (AD-IOL) with zonular capture haptics (ZCH) in a Rhesus monkey animal model at physiologic levels of accommodation via stimulation of the Edinger-Westphal midbrain nucleus. This device requires two procedures. Standard implantation results in monofocal phakic vison. Activation releases the device mobility a few weeks later and results in restoration of accommodation. We developed and evaluated a non-invasive activation procedure.

Setting:

Wisconsin National Primate Research Center.

Methods:

A primate AD-IOL prototype, with a 4 mm single silicone optic and Zonula Capture Haptics, was implanted in 6 Rhesus monkeys eyes. After an inter-operative period of capsular fibrosis, the activation procedure was performed in 3 eyes using a non-invasive YAG laser and a surgical procedure in the contralateral eyes. Radial capsular sectioning was done with the YAG laser in 3 eyes only. The amount of axial shift of the optic, flexion of the haptics and refractive change were determined by Visante OCT, UBM-E, UBM -H, Scheimpflug and Hartinger objective refraction. Accommodation was stimulated via the EW nucleus.

Results:

All AD-IOL’s showed excellent capture of zonular forces and a pronounced movement during accommodation. The 3 eyes that underwent both non-invasive activation and a modified capsular sectioning with the YAG laser demonstrated up to 0.77mm of axial shift and 20 degrees of haptic flexion. There was a pronounced difference between the eyes with and without capsular sectioning. The refractive changes exceeded theoretical predictions and are consistent with a successful AD-IOL in human subjects. The non-invasive approach to the second procedure represents a much simpler, safer and more viable alternative to surgical intervention.

Conclusions:

This AD-IOL primate prototype captures zonular forces and responds to ciliary muscle contraction in unprecedented way. The movement dynamics of Zonular Capture Haptics can be readily converted into accommodation with either single or double solid optics or small, reservoir free, fluid filled optics. Non-invasive second stage activation surgery allows sufficient reduction in the restriction caused by the post-operative fibrosis of the capsular bag to make this single solid optic AD-IOL prototype viable for consideration in human subjects.

Financial Disclosure:

... gains financially from product or procedure presented