Variations in manufacturing quality of diffractive multifocal lenses.

The new generation of multifocal intraocular lenses (IOLs) based on diffraction optics is characterized by a stepped discontinuity at zone boundaries on the posterior surface of the IOL optic. The step height at the zone boundaries is less than 2 microns. There are approximately 30 zones on a 6 mm diameter lens, requiring manufacturing precision of about 0.02 mm. Various companies produce this type of lens. On two implanted lenses we found, in addition to the 2 microns boundaries, many small circular rims that appeared to be manufacturing artifacts. The presence of these artifacts may explain the variable clinical acceptance of these IOLs.

Protective effect of the anterior lens capsule during extracapsular cataract extraction. Part I. Experimental animal study.

In an experimental study using albino Rex rabbits, the intercapsular cataract extraction (ICCE) technique was performed in 20 eyes with a small anterior capsulotomy. A large, can opener capsulotomy was performed in another 20 eyes, and 10 unoperated eyes served as controls. Endothelial cell loss was determined by vital staining with Trypan blue and Alizarin red S stains. Average endothelial cell loss with the ICCE technique was 1.2%; with the can opener technique, the average cell loss was 6.6%. This difference was statistically significant (P less than 0.01). The percentage of endothelial cell loss in the control eyes was 0.5. A positive correlation between endothelial cell loss related to phacoemulsification time and/or the amount of irrigating fluid used existed for the can opener group only (P less than 0.01). These results demonstrate that the presence of an almost intact anterior lens capsule during removal of lens substance is protective to the corneal endothelium.