Long-Term Refractive And Quality Of Vision Outcomes 24 Months After Implantation Of A Modular, Anterior Shape-Changing, Fluid-Optic Intraocular Lens.

Published 2022 - 40th Congress of the ESCRS

Reference: PP16.07 | Type: Free paper | DOI: 10.82333/65c6-5z20

Authors: Thomas Kohnen* ¹ , Eric Donnenfeld ² , Sumit Garg ³ , Uday Devgan ⁴ , Rosa Braga-Mele ⁵ , Kerry Assil ⁶ , Kerry Solomon ⁷ , Enrique Barragan ⁸ , Arturo Chayet ⁹

¹Department of Ophthalmology,Goethe University,.,Germany, ²Ophthalmic Consultants of Long Island,New York,United States, ³Gavin Herbert Eye Institute,University of California,Irvine,United States, ⁴Devgan Eye Surgery,Beverly Hills,United States, ⁵Kensington Eye Institute,Toronto,Canada, ⁶Assil Eye Institute of Los Angeles,Los Angeles,United States, ⁷Carolina Eyecare Physicians,Charleston,United States, ⁸OcuMed,Monterrey,Mexico, ⁹CODET Vision Institute,Tijuana,Mexico

Purpose

To assess the long-term refractive outcomes and contrast sensitivity in eyes implanted with the Juvene intraocular lens (LensGen, Inc, Irvine, CA). The Juvene IOL (JIOL) is a unique, modular, anterior shape-changing, fluid-optics intraocular lens (IOL) which is designed to provide monofocal-like distance vision and contrast sensitivity while utilizing an active shape-changing mechanism to provide improved intermediate and near vision.

Setting

This study was conducted at two private clinics: 1) CODET Vision Institute in Tijuana, Mexico; and 2) Dr. Enrique Barragán in Monterrey, Mexico. Enrollment was split evenly between the two sites, but the bulk of long-term follow up visits occurred in Monterrey (23 of 27 eyes) due to local COVID-19 restrictions.

Methods

Patients underwent standard small-incision cataract phacoemulsification followed by implantation of a JIOL. The JIOL consists of 2 components, a base lens with circumferential, capsule-filling haptics, and a fluid lens with a flexible anterior membrane that rests within the base lens. Postoperative measures included monocular and binocular corrected distance visual acuity (CDVA), defocus curves at 4 meters; distance-corrected intermediate visual acuity (DCIVA) at 66 cm; and distance-corrected near visual acuity (DCNVA) at 40 cm. Monocular mesopic (3 cd/m²) contrast sensitivity with and without glare was also assessed. All visual acuities were conducted using the Electronic VA System and Clinical Trial Suite software (M&S Technologies).

Results

Twenty-seven eyes of 19 patients were assessed 24 months postop. Mean (± SD) monocular CDVA was logMAR -0.03 (20/20⁺¹; ±0.07). Mean DCIVA and DCNVA were 0.12 (20/25^-1; ±0.09) at intermediate and 0.28 (20/40⁺¹; ±0.11) at near. Binocular CDVA was -0.08 (20/16^-1; 0.06); binocular DCIVA and DCNVA were 0.08 (20/25⁺¹; 0.07) and 0.14 (20/25^-2; 0.09), respectively. Monocular defocus curves showed greater than 1.5 D depth of focus at logMAR 0.2 (20/32) and nearly 2.5 D depth of focus at logMAR 0.3 (20/40). Binocular defocus curves showed greater than 2.0 D depth of focus at 0.2 and nearly 3.0 D depth of focus at 0.3. Contrast sensitivity functions with and without glare were indistinguishable from a monofocal IOL measured with the same system.

Conclusions

These long-term 24 month results suggest the biomimetic Juvene IOL provides an enduring full range of vision from distance through near via its dynamic shape-changing mechanism. Due to the non-light-splitting design, there also appears to be no reduction in contrast sensitivity when compared to a monofocal IOL, the gold standard for contrast sensitivity. This provides an important potential benefit over light-splitting premium IOLs currently on the market. Patients will be returning for 36 month follow up to evaluate the continued stability of these outcomes.