ACCOMMODATIVE IOL

An innovative accommodative intraocular lens (IOL), the FluidVision® IOL (PowerVision), provided patients with good visual acuity (VA) at all distances, the results of a clinical study indicate. The FluidVision® IOL harnesses tiny natural muscular forces in the eye to move fluids inside the lens, mimicking natural accommodation through shape change, Frik Potgieter MD, FRCS, Pretoria, South Africa, told delegates at the XXXIII Congress of the ESCRS in Barcelona, Spain.

Dr Potgieter and colleagues completed a single-site, two-surgeon study of 26 patients to assess accommodation, visual quality and long-term visual outcome and stability. Follow-up was 24 months, and eight of the 26 patients received a second implant into the fellow eye at 15-21 months after initial surgery.

The average best distance corrected binocular acuities available for seven patients at one month were: logMAR -0.05 +/- 0.05 at distance; logMAR 0.05 +/- 0.06 at intermediate, 66cm; and logMAR 0.16 +/- 0.16 at near, 40cm. Binocular intermediate and near VAs were about one line better than monocular acuities.

Average monocular uncorrected distance VA at one month was logMAR -0.01 (20/20+), and binocular uncorrected distance acuity was logMAR 0.00 (20/20). Average monocular and binocular accommodative amplitude measured by defocus was 3.12D and 4.19D, respectively.

CONTINUUM OF FOCUS

“The FluidVision® accommodative IOL demonstrates excellent binocular VA at distance, intermediate and near. What further distinguishes this type of accommodative IOL is the continuum of focus from near to distance,†Dr Potgieter said.

“Contrast sensitivity was superior to standard diffractive multifocal IOLs in both mesopic and mesopic glare conditions. Indeed, contrast sensitivity is comparable to a monofocal IOL,†he added.

Stability and safety were observed out to 24 months after implantation. Endothelial cell counts were normal for intraocular surgery.

'The FluidVision® consists of a refractive index-matched silicone fluid-filled optic connected by channels to two fluid-filled haptics. The act of accommodation forces fluid from the haptics into the optic, thereby increasing thickness and optical power. Upon dis-accommodation, fluid flows back into the haptics,â€
he explained.

The silicone oil inside the lens is the same as the oil used in vitreoretinal surgery. If the lens required removal, oil aspiration via a needle inserted into the lens cavity leads to collapse of the lens, making it possible to explant it similar to a conventional IOL.

“The three-dimensional device is inserted into the capsular bag and then rotated so that the haptics come to rest in the horizontal position,†he said.

After the initial healing period, there were no signs of inflammation, and the lens remained stable and centred in all cases, he said.

Frik Potgieter: fjp@lasik.co.za