Iols Design And Material Influence In Nd: Yag Laser Rates For A Large Series Of Mics Iol Implantations.

To study the cumulative neodymium: YAG (Nd:Yag) laser rate (capsulotomy for posterior capsular opacification) after 9431 implantations during cataract surgery of 11 different hydrophilic acrylic MICS lenses and 2 hydrophobic and evaluate the influence of material and design. 

Centre Ophtalmologique IRIDIS, Albi, France.

This retrospective study comprises all patients who were implanted between 2004 and the end of 2021 with one of the after 13 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), Lucidis 108 & 124 M/MT (SAV-IOL). The postoperative follow-up ranges from 1 to 201 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.

The 1,5 years survival percentage was 100% for the INCISE, PODEye, Lucidis 108M/MT (95% CI: 100-100); 85,09% for the Akreos MICS (CI: 81-88); 96,09% for the CT Asphina (CI: 94-97); 99,78% for the AT TORBI (CI: 99-100); 93,59% for the MicroSlim (CI: 91-95); 93,69% for the Micro AY (CI: 92-95); 95,74% for the MicroPure (CI: 93-97); and 92,33% for the Ankoris (CI: 87-95), 97,43% for the Synthesis (CI: 84-100), 94,67% for the Synthesis Toric (CI: 68-98), and 90,00% for the Lucidis 124M/MT (CI: 50-98). The 11 years survival percentage was 13,56% for the Akreos MICS (95% CI: 9-19); 31,93% for the CT Asphina (CI: 26-38); 60,80% for the MicroSlim (CI: 55-66); 50,58% for the Micro AY (CI: 47-54). 

The analysis of this large series of IOL shows a better survival rate for the 22% hydrophilic Incise, and the worst for the 26% acrylic hydrophilic Akreos MICS. Moreover, the plate haptics design seems to have a better result to delay the PCO, with a difference between AT TORBI 709 and CT Asphina. The influence of the hydrophobic material to delay the PCO seems to be less effective than the design and industrial process of fabrication.