Light scattering assessment of different hydrophobic acrylic intraocular lenses with glistenings

Session Details

Session Title: IOL Dislocation & Opacification

Session Date/Time: Tuesday 25/09/2018 | 14:00-16:00

Paper Time: 15:18

Venue: Room A3, Podium 1

First Author: : G.Labuz GERMANY

Co Author(s): :    R. Khoramnia   D. Knebel   H. Fang   T. van den Berg   G. Auffarth        

Abstract Details

Purpose:

In clinical and laboratory studies, glistenings have most often been associated with AcrySof material, however, other hydrophobic acrylic platforms can also be susceptible to this postoperative complication. Moreover, glistening formation might not have similar morphology in different intraocular lenses (IOL), and thus their scattering effects might also differ. The goal of this research was (1) to study the process of in vitro glistening formation in different hydrophobic IOLs; (2) to assess the effect of (accelerated) IOL aging on light scattering by means of straylight measurements.

Setting:

David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Germany.

Methods:

The following IOL models (five per group) were studied: Aktis SP (Nidek), SN60WF and MA60AC (Alcon), CT Lucia (Zeiss), PY60AD (Hoya) and Avansee (Kowa). The lenses were immersed in a balanced salt solution at 45°C for 24 hours and transferred to a water bath at 37°C for 2.5 hours. Gross examination and image recording were performed using a light microscope with a temperature-controlled stage. Images were processed with a custom-made program that provided descriptive statistics of identified microvacuoles (MV). Straylight was measured using a C-Quant (Oculus) device adapted for in vitro IOL assessment.

Results:

Glistenings were found in all lens models, except Avansee. The glistening number differed between the IOL groups. For SN60WF it was 61MV/mm2, for MA60AC it was 542MV/mm2, for CT-Lucia it was 85MV/mm2, and for PY60AD it was 3532MV/mm2. The Aktis-SP IOLs showed glistenings only in the lens periphery (352MV/mm2) and increased diffuse light scattering in the lens center. The glistenings size ranged from 5.2 to 10.2μm. The mean straylight parameter of the IOLs prior and after accelerated IOL aging ranged, respectively, from 0.1 to 1.3deg2/sr and 0.95-19.30 deg2/sr. A straylight increase was associated with the glistenings number.

Conclusions:

We confirmed that straylight increases with the glistenings number irrespective of the IOL material and the morphology of the glistenings. A large number of glistenings does cause increased straylight, and thus may result in glare symptoms. We showed that hydrophobic-acrylic IOL models differed in their response to the accelerated aging procedure, as the models studied demonstrated differences in morphology (grades, sizes and locations) of glistenings. Moreover, we found important variability in the glistening numbers within groups with IOLs of the same model, but the reason for that remains to be elucidated.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... travel has been funded, fully or partially, by a competing company, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a competing company, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company