ACCOMMODATION WITHOUT HAPTICS

The WIOL-CF, a new accommodating IOL designed to mimic the geometry and plasticity of the crystalline lens, can provide stable refraction and some measure of accommodation, reports Ioannis Pallikaris MD, Institute of Vision and Optics, University of Crete School of Medicine, Heraklion, Crete, Greece. “The WIOL-CF appears to be a very promising alternative solution for patients that lead an active life and require good vision for near, intermediate and far. In our patient series all patients obtain some level of accommodation which remained stable throughout the follow-up,†he told the 16th ESCRS Winter Meeting.

Dr Pallikaris presented the results of a study involving 50 eyes of 25 patients who underwent routine cataract surgery and implantation of WIOL-CF accommodative intraocular lens. He noted that at a mean follow-up of two years the mean logMAR uncorrected distance visual acuity improved from 0.34 preoperatively to 0.16. In addition, corrected distance visual acuity improved from 0.25 to 0.08, 71 per cent of eyes gained lines of corrected distance visual acuity, and no eyes lost any lines. Furthermore, the uncorrected near visual acuity – as tested with Birkhauser reading charts at a distance of 33.0cm under photopic conditions – was J3 or better in all eyes, J2 or better in 72 per cent of eyes, and J1 or better in 40 per cent of eyes, Dr Pallikaris said. He noted that the IOL has no haptics and a diameter ranging from 8.6mm to 9.0mm. The lens has a meniscoid anterior surface and a hyperbolic posterior surface. Its optical design is intended to provide up to 2.5 D of accommodation. The IOL is implantable through a 2.8mm incision in its dehydrated state using a cartridge, and expands to its fully rehydrated state within the first 48 postoperative hours.

“The only thing is that you really have to be careful while putting the lens inside the cartridge to make sure that you don't insert the lens upside down, although this is easy enough to do this given the shape difference between the front and back,†Dr Pallikaris said. He noted that the IOL’s hydrogel material has a high water content to provide high biocompatibility and permeability. Moreover, the lens has a negatively charged surface that helps prevent protein deposits, cell attachment and opacification of the posterior capsule. Moreover, the posterior surface of the lens comes into contact with posterior capsule in much the same manner as does the natural crystalline lens, which, together with its sharp-edged continuous rim, provides further protection against PCO. “No complications occurred during surgery or afterwards. A larger series of patients with longer follow-up will be necessary in order to confirm the study’s encouraging results,†Dr Pallikaris concluded.