Clinical Outcomes of Aspheric 1-Piece (Tecnis(R) ZCB00) and 3-Piece (Tecnis(R) ZA9003) Aspheric Intraocular Lens for 12 Months

PURPOSE: To evaluate the postoperative outcome of Tecnis(R) ZCB00 1-Piece acrylic intraocular lens (IOL), the new single piece, aspheric IOL until 12 months. METHODS: Sixty eyes undergone cataract surgery using two different IOLs; The Tecnis(R) ZCB00 1-Piece Acrylic IOL (30 eyes) and the Tecnis(R) ZA9003 3-Piece Acrylic IOL (30 eyes). Cataract surgery was performed in the same period. All complicated cases were excluded. Best corrected visual acuity (BCVA), refractive error, photopic and mesopic contrast sensitivity, total high order aberration, spherical aberration and anterior chamber depth were measured preoperatively and at 1, 6 and 12 months after surgery. RESULTS: There were no statistically significant differences between two groups in BCVA, refractive error, total high order aberration and spherical aberration all the time after surgery. Both groups have negative ocular spherical aberration until 12 months after surgery. 1-piece and 3-piece groups had different tendency in axial movement. But there were no statistically significant differences in anterior chamber depth measured at 1 week, 1, 6 and 12 months after surgery. There was no statistically significant difference in contrast sensitivity at 1, 6 and 12 months after surgery. CONCLUSIONS: The Tecnis(R) ZCB00 1-Piece acrylic intraocular lens (IOL) showed comparable clinical outcomes to the Tecnis(R) ZA9003 3-Piece acrylic intraocular lens (IOL) until 12 months after cataract surgery. 1-piece and 3-piece IOL group had different tendency in axial movement. However, refraction remained stable during 12 months after surgery. Mostly, both IOL groups had negative ocular spherical aberration during whole follow-up period.

A Case of Hydrophilic Acrylic Intraocular Lens Opacification in a Patient with Proliferative Diabetic Retinopathy

PURPOSE: To report a case of hydrophilic acrylic intraocular lens (IOL) opacification in a patient who underwent vitrectomy and cataract surgery for the treatment of diabetic retinopathy. CASE SUMMARY: A 54-year-old female complained of blurred vision for 15 months after having combined vitrectomy and phacoemulsification with IOL (Rayner(R) Superflex(R) 620H) implantation for the treatment of high-risk proliferative diabetic retinopathy. On slit-lamp examination, IOL opacification was evident. IOL exchange was performed and the explanted IOL analyzed. Scanning electron microscopy (SEM) revealed the presence of translucent granular deposits on the anterior subsurface of the IOL. Energy dispersive X-ray spectroscopy (EDS) demonstrated calcium and phosphate deposition within the IOL optic.

Surgical Results of Transscleral Fixation of Foldable Acrylic Intraocular lens with Unique Shape of Haptics

PURPOSE: To report the surgical results of transscleral fixation of foldable acrylic intraocular lens with a unique haptic shape (CORNEAL(R), ACR6D, France). METHODS: We analyzed the medical records of 18 patients (19 eyes) who had transscleral fixation of posterior chamber intraocular lens implantation from July 2004 to July 2006. RESULTS: According to the cause of operation, there were five eyes with complicated cataract, eight with trauma, and six with aphakia associated with a previous operation. The mean age of the patients was 55.9+/-21.2 years. The mean preoperative best-corrected visual acuity was 0.31+/-0.35, and the postoperative value was 0.63+/-0.29 (p<0.05). The mean preoperative spherical refractive equivalent was 6.58+/-5.33 diopter, and the postoperative value was -1.77+/-1.59 diopter. The mean refractive error was -1.13+/-1.57 diopter. This showed a myopic shift (p<0.05). The mean astigmatism decreased with time, and it stabilized two months after the operation. The trend was toward mild against-the-rule astigmatism. The mean follow-up duration was 11.0+/-7.6 months. CONCLUSIONS: In eyes with inadequate capsular support, transscleral fixation of posterior chamber intraocular lens implantation with CORNEAL(R) lenses is a safe and effective procedure for visual correction.

Postoperative Deposition of Calcium on the Surface of a Hydrophilic Acrylic IOL in Diabetic Patients

PURPOSE: Through a study of 3 diabetic patients who experienced decreased visual acuity due to deposit on the surface of hydrophilic acrylic IOLs which were inserted after cataract extraction, the authors attempted to examine pathological and histochemical characteristics of such undesirable deposit on the IOL surface and also evaluate whether a correlation exists between that and diabetes mellitus. METHODS: A 42 year old male patient with bilateral proliferative diabetic retinopathy who has had diabetes for 10 years, a 43 year old male with identical clinical history, and a 46 year old male with bilateral proliferative diabetic retinopathy and clinically significant macular edema who has had diabetes for 13 years were selected for the study. Cataract was extracted by phacoemulsification and after hydrophilic acrylic IOL was inserted into the bag, deposit appeared on IOL surface which caused decreased visual acuity. IOL exchange was conducted thereafter, and by studying the pathological and histochemical characteristics of deposit found on the surface of the retrieved IOL, and by examining the deposit's fine details with electron microscope, the authors attempted to identify the causative material and also evaluate whether diabetes plays a significant role in giving rise to such undesirable deposit. RESULTS: All three IOL that have been retrieved from the patients were covered with multiple deposits which took on a structure with fine circular granules, and all these deposits tested positive when 1% alizarin red staining and von Kossa staining (designed to identify calcium in a given material) were conducted. Electron microscopic study of the deposit also showed needlelike calcium crystals.

A clinical comparison of SI40NB and MA60BM IOLs: One year result

PURPOSE: To evaluate and compare the clinical results of implantation of foldable silicone(SI40NB, PhacoFlexIITM, AMO) intraocular lenses(IOLs) and acrylic(MA60BM, AcrySofTM, Alcon) IOLs. METHODS: Seventy eyes of 35 healthy senile cataract patients who had uneventfully implanted silicone IOL in one eye and acrylic IOL in the other eye were observed on their best corrected visual acuities(BCVA) and postoperative complications such as posterior capsule opacification(PCO) with its incidence and site. RESULTS: Mean postoperative follow-up period was 17.6month +/-2.08(S.D.)(range 13 to 20 months). Postoperative BCVA, with the measurement of above 0.8 was 29% in SI40NB-IOL implanted group(S group) and 37% in MA60BM-IOL implanted group(M group), above 0.5 was 88.4% in S group and 100% in M group. PCO was 19 eyes(54.3%) in S group and 5 eyes(14%) in M group. Anterior capsular contracture was 3 eyes(8.6%) in S group and 1 eye(2.9%) in M group. Two eyes(5.7%) of capsular capture and 3 eyes(8.6%) of decentration(1<1.5 mm) were only in S group. Eight eyes(22.9%) of microvacuole were only in M group. A eye of S group with severe PCO had taken Nd:YAG posterior capsulotomy. To evaluate the PCO character, posterior capsule was imaginary divided into central part and peripheral part at IOL's optic edge. In M group, among 5 eyes(14.3%) of peripheral part opacification, a eye(2.9%) was progressed into central part. In S group, among 19 eyes(54.3%) of peripheral part opacification, 11 eyes(31.4%) were progressed into central part. There was 20% central progression rate in M group and 57.9% in S group. CONCLUSIONS: MA60BM-IOL showed good visual outcome and fewer postoperative complication than SI40NB-IOL, especially in central PCO which is closely related visual outcome.

A Clinical Comparison of AcrySof(r) with Hyd rophilic Acrylic IOLs

To evaluate and compare the clinical results of implantation of the AcrySof(r) with Hydrophilic Acrylic IOLs in early postoperative period(to 2 months), we retrospectively analyzed 34patients who had taken clear cornea incision and had been implanted with AcrySof(r)IOL in one eye and Hydrophilic Acrylic IOL in the other eye. There were no stastically significant difference in postoperative best corrected visual acuity, preoperative and postopearative astigmatic changes between AcrySof(r) and Hydrophilic Acrylic IOLs. But, the rates of postoperative capsular fibrosis and contracture of Hydrophilic Acrylic IOL was higher than those of AcrySof(r) IOL as well as postoperative complications. In conclusion, in the degree and rate of after-cataract, AcrySof(r)IOLs are more useful than Hydrophilic Acrylic IOLs. ;therefore, more excellent in long term visual prognosis. Further studies will be needed for the evaluation of clinical safety and efficacy.

The Apparent Accommodation after Implantation of Posterior Chamber Intraocular Lenses: Acrylic and Silicone

PURPOSE: We compared the apparent accommodative power of acrylic intraocular lens(IOL) with silicone IOL after implantation of IOL into the bag. METHODS: In 36 senile catatact patients(40 eyes)visited St. Mary's hospital from July 1999 to June 2000, the IOL was inserted into the capsular bag after continuous curvilinear capsulorhexis. All of them were over 60 years old. We checked corrected visual acuity, pupil diameter and apparent accommodative power by accommodometer(AA2000, Nidek, Japan) preoperatively and 1 day, 1 month, 2 months after surgery. The used IOLs were two groups, ones are Acrysof (Alcon, U.S.A.) in 20 eyes and the others are Soflex (Chiron vision, U.S.A.) in 20 eyes. RESULTS: The investgation revealed that the apparent accommodative power reached its peak at 1 month after surgery. There was no stastically significant difference(p>0.05) between acrylic IOL and silicone IOL in apparent accommodative power at 2 months after surgery. CONCLUSIONS: The analysis revealed that the pupil size had significant negative correlations with apparent accommodative power at each other group, whereas corrected visual acuity and refraction error showed no relationship with apparent accommodative power.

The Changes in the Area of the Anterior Capsulotomy Size

PURPOSE: To investigate whether there was any difference in anterior capsular opening area between the use of silicone intraocular lens(IOL) and acrylic IOL after continuous curvilinear capsulorhexis(CCC). METHODS: In 42 eyes, acrylic IOL(Acrysof(R), Alcon, U.S.A.) were inserted into the capsular bag during phacoemulsification, and in 36 eyes silicone IOL(Chiroflex II(R) , Chiron, U.S.A.) were inserted. The reduction rate of anterior capsular opening area at first, second, third and sixth postoperative month were compared between the two groups. RESULTS: On the whole, the reduction in anterior capsular opening area was larger by 0.574 mm 2 when silicone IOL was used, but the different was not statistically significant(P= .061). The result was the same at 1 month(P= .149), 2 months(P= .144), 3 months(P= .223), 6 months(P= .163) after surgery. CONCLUSIONS: We concluded that there was little difference in the changes of anterior capsular opening area after CCC between the use of silicone IOL and acylic IOL, and other factors should be considered.