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IOLs design and material influence in Nd:Yag laser rates and CME occurrence for a large series of MICS IOL implantations

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First Author: G.Lesieur FRANCE

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Abstract Details

Purpose:

To study the cumulative neodymium: YAG (Nd:Yag) laser rate (capsulotomy for posterior capsular opacification) after 8493 implantations during cataract surgery of 9 different hydrophilic acrylic MICS lenses and 2 hydrophobic and evaluate influence of material and design. Analysis of CME occurrence before and after ESCRS recommendation.

Setting:

Centre Ophtalmologique IRIDIS, Albi, France.

Methods:

This retrospective study comprises all patients who were implanted between 2006 and the end of 2019 with one of the after 11 micro-incision IOLs: Akreos MICS and INCISE (Bausch and Lomb), CT Asphina 509 M/MP and AT TORBI 709 M/MP (Carl Zeiss Meditec), Synthesis and Synthesis Toric (Cutting Edge) MicroSlim, Micro AY, MicroPure, Ankoris and PodEye (BVI-PhysIOL). The postoperative follow-up ranges from 1 to 168 months. The cumulative Nd: Yag laser frequency rates in all groups were calculated, and the cumulative incidence rates were defined by propensity score, Weighted Cox regression, Tuckey test, Kaplan-Meier survival analysis and Mann-Withney test.

Results:

The 2 years survival percentage was 100% for the INCISE (95% CI: 100-100); 71,73% for the Akreos MICS (95% CI: 67-76); 92,70% for the CT Asphina (95% CI: 91-94); 99,31% for the AT TORBI (95% CI: 99-100%); 88,81% for the MicroSlim (95% CI: 86-91); 88,81% for the Micro AY (95% CI: 87-90); 92,10% for the MicroPure (95% CI: 88-95); 49,87% for the Ankoris (95% CI: 19-75); 100% for the PODEye (95% CI: 100-100); Synthesis 100% (95% CI: 100-100) and Synthesis Toric 100% (95% CI: 100-100). The 9 years survival percentage was 13,62% for the Akreos MICS (95% CI: 9-19); 31,73% for the CT Asphina (95% CI: 27-37); 64,19% for the MicroSlim (95% CI: 58-69); 50,48% for the Micro AY (95% CI: 47-54). Statistical analysis on CME shows a rate of 1.71% before 12/2018 and 0.57% after the systematic use of per op subconjunctival Dexamethasone according to ESCRS recommendation (pvalue = 0.03221). In addition, the analysis shows that the group of patients with CME had lower CDVA (median = 7) before the use of Dexamethasone than after (median = 9.5; pvalue = 0.02638).

Conclusions:

IOL design influence ND:Yag rate and same design with different material doesn’t seem, so far, have different issue for all the design. The CME rate has decreased and CDVA has been less impacted since the systematic subconjunctival dexamethasone injection. All impacts of the IOL design will be discuss.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented