In-vitro glistening formation in six different foldable hydrophobic intraocular lenses

Abstract Background Glistenings describe small, refractile microvacuoles that may arise within the intraocular lens (IOL) material and reduce the patients’ quality of vision. Lenses composed of hydrophobic acrylic material are particularly affected by glistening formation. In this study, we compared the tendency of glistening formation in six different types of hydrophobic acrylic intraocular lenses (IOLs). Methods We used a well-established accelerated laboratory method to develop glistenings in the following IOLs: Vivinex XY1 (Hoya), AcrySof SN60WF (Alcon), Tecnis ZCB00 (AMO), Avansee PN6A (Kowa), Aktis SP NS-60YG (Nidek), and CT Lucia 601P (Zeiss). IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h in a water bath. Microvacuole (MV) density and size (Miyata grading) were documented and calculated using an image analysis program. Results The mean glistening density [MV/mm2] and mean Miyata grading (in brackets) were: Vivinex: 11.6 ± 5.7 (0), SN60WF: 264.4 ± 110.3 (2.6), Tecnis: 6.0 ± 2.8 (0), Avansee: 2.2 ± 0.7 (0), Aktis: 851.4 ± 59.4 (3+) and CT Lucia: 71.0 ± 71.6 (1). Conclusions While all tested IOLs showed glistenings with the accelerated laboratory method, the Aktis and SN60WF showed the highest microvacuole density, followed by the CT Lucia. In comparison, the Vivinex, Tecnis, and Avansee IOLs showed far fewer number of glistenings.

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Comparative analysis of in vitro accelerated glistening formation in foldable hydrophobic intraocular lenses

International Ophthalmology ◽

10.1007/s10792-021-01870-6 ◽

2021 ◽

Author(s):

Tamer Tandogan ◽

Gerd U. Auffarth ◽

Chul Young Choi ◽

Hyeck-Soo Son ◽

Ramin Khoramnia

Keyword(s):

Image Analysis ◽

Comparative Analysis ◽

Clinical Results ◽

Laboratory Method ◽

High Density ◽

Intraocular Lenses ◽

Analysis Program ◽

Different Types ◽

Hydrophobic Acrylic

Abstract Purpose To analyse and compare the propensity to form glistenings in 4 different types of hydrophobic acrylic intraocular lenses (IOLs): Alcon AcrySof ® MA60AC, HOYA iSert® PC-60AD, Bausch&Lomb enVista, and Kowa Avansee™ PU6A. Methods We used an accelerated laboratory method to create glistenings. IOLs were first immersed in saline at 45 °C for 24 h and then at 37 °C for 2.5 h. Microvacuole (MV) density and size were documented and calculated using an image analysis program. Results Median density of glistenings [MV/mm2] for Alcon AcrySof ® MA60AC was 623 (range 507–804), for HOYA iSert® PC-60AD 1358 (range 684–2699), for Bausch&Lomb enVista 2 (range 1–2), and for Kowa Avansee™ PU6A 1 (range 1–4). The prevailing MV size was: 0–5 µm for Hoya IOLs, 5–10 µm for Alcon IOLs, 20–50 µm for Bausch&Lomb IOLs, and 5–50 µm for Kowa IOLs. Conclusions Glistenings could be induced in all studied IOLs using the accelerated laboratory method. The Alcon AcrySof ® MA60AC and HOYA iSert® PC-60AD IOLs showed MV of high density, while the glistenings in the Hoya IOLs were smaller in size compared to the Alcon IOLs. The MV density was minimal in the Bausch&Lomb enVista and Kowa Avansee™ PU6A IOLs. The propensity of the Alcon AcrySof ® MA60AC IOLs to form glistenings in vitro correlated with the findings of clinical results that are already published.

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The material quality of a new hydrophobic acrylic intraocular lens

10.21203/rs.2.16427/v1 ◽

2019 ◽

Author(s):

Timur M. Yildirim ◽

Hui Fang ◽

Sonja K. Schickhardt ◽

Qiang Wang ◽

Patrick R. Merz ◽

...

Keyword(s):

Stress Test ◽

Mean Value ◽

Laboratory Method ◽

Intraocular Lenses ◽

Fort Worth ◽

In Vitro Stress ◽

Vision Care ◽

Hydrophobic Acrylic

Abstract Background The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well established in-vitro laboratory method, we evaluated a new IOL material’s resistance to glistenings formation. Methods An in-vitro stress test for glistenings induction was performed on twenty samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm 2 ) was evaluated in five sections of each IOL. The results for each model were compared and rated on the Miyata Scale for grading glistening severity. Results In all cases, glistenings number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm 2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm 2 . The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm 2 . Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero. Conclusion In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. In clinical use, one can confidently expect glistenings numbers will be low and clinically irrelevant in the Eyecryl ASHFY600.

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Glistening formation in a new hydrophobic acrylic intraocular lens

10.21203/rs.2.16427/v2 ◽

2020 ◽

Author(s):

Timur M. Yildirim ◽

Hui Fang ◽

Sonja K. Schickhardt ◽

Qiang Wang ◽

Patrick R. Merz ◽

...

Keyword(s):

Stress Test ◽

In Vitro Study ◽

Mean Value ◽

Laboratory Method ◽

Intraocular Lenses ◽

Fort Worth ◽

In Vitro Stress ◽

Vision Care ◽

Hydrophobic Acrylic

Abstract Background: The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well-established in-vitro laboratory method, we evaluated a new IOL material’s resistance to glistening formation. Methods: An in-vitro stress test for glistening induction was performed on twenty samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm 2 ) was evaluated in five sections of each IOL. The results for each model were compared and rated on the Miyata Scale for grading glistening severity. Results: In all cases, glistening number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm 2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm². The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm². Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero. Conclusion: In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. Results from this in-vitro study suggest that glistening numbers will be low in clinical use in the Eyecryl ASHFY600.

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Visual outcomes and patient satisfaction 1 and 12 months after combined implantation of extended depth of focus and trifocal intraocular lenses

International Ophthalmology ◽

10.1007/s10792-021-01970-3 ◽

2021 ◽

Author(s):

Richard N. McNeely ◽

Salissou Moutari ◽

Stephen Stewart ◽

Jonathan E. Moore

Keyword(s):

Intraocular Lenses ◽

Depth Of Focus ◽

Lens Extraction ◽

Extended Depth Of Focus ◽

Quality Of Vision ◽

Trifocal Iol ◽

The Mean ◽

Functional Vision ◽

Subjective Outcomes

Abstract Purpose To assess the 1-month and 12-month postoperative visual performance and subjective outcomes following combined implantation of an extended depth of focus (EDOF) intraocular lens (IOL) and a trifocal IOL. Methods The study enrolled consecutive patients undergoing refractive lens extraction or cataract surgery with combined implantation of an EDOF IOL (dominant eye) and trifocal IOL. Uncorrected (UDVA) and best-corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, and subjective questionnaires were evaluated 1 month and 12 months postoperatively. Results The study enrolled 58 consecutive patients. Binocular UDVA, UIVA and UNVA were − 0.08 ± 0.07 logMAR, 0.15 ± 0.14 logMAR and 0.17 ± 0.11 logMAR at 1 month, compared to − 0.09 ± 0.06 logMAR (P = .323), 0.11 ± 0.10 logMAR (P = .030) and 0.13 ± 0.10 logMAR (P = 0.008) at 12 months. Satisfaction was high with 93.1% of patients fulfilled or more than fulfilled postoperatively, and 84.5% and 86.3% reported spectacle independence for near at the respective postoperative assessments. The mean daytime and nighttime quality of vision (QoV) scores were 9.12 ± 0.94 and 7.88 ± 1.74 at 1 month, compared to 9.24 ± 0.78 (P = .183) and 8.26 ± 1.38 (P = .043) at 12 months. Conclusions This IOL combination provides good unaided visual acuity at 1 and 12 months postoperatively, with high functional vision and postoperative satisfaction reported at 1 and 12 months. However, a significant improvement in overall nighttime QoV at the 12 months assessment was found.

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Glistening formation in a new hydrophobic acrylic intraocular lens

10.21203/rs.2.16427/v3 ◽

2020 ◽

Author(s):

Timur M. Yildirim ◽

Hui Fang ◽

Sonja K. Schickhardt ◽

Qiang Wang ◽

Patrick R. Merz ◽

...

Keyword(s):

Stress Test ◽

In Vitro Study ◽

Mean Value ◽

Laboratory Method ◽

Intraocular Lenses ◽

Fort Worth ◽

In Vitro Stress ◽

Vision Care ◽

Hydrophobic Acrylic

Abstract Background: The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well-established in-vitro laboratory method, we evaluated a new IOL material’s resistance to glistening formation.Methods: An in-vitro stress test for glistening induction was performed on twenty samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm2) was evaluated in five sections of each IOL. The results for each model were compared and rated on the Miyata Scale for grading glistening severity.Results: In all cases, glistening number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm². The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm². Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero.Conclusion: In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. Results from this in-vitro study suggest that glistening numbers will be low in clinical use in the Eyecryl ASHFY600.

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Comparative Surface Imaging Study of Multifocal Diffractive Intraocular Lenses

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1328-2550 ◽

2021 ◽

Author(s):

Hyeck Soo Son ◽

Jung Min Lee ◽

Ramin Khoramnia ◽

Chul Young Choi

Keyword(s):

Imaging Study ◽

The Other ◽

Intraocular Lenses ◽

Optical Surface ◽

Diffractive Optic ◽

Atomic Force ◽

Acceptable Range ◽

Different Types ◽

Concentric Pattern

Abstract Purpose To analyse and compare the surface topography and roughness of three different types of diffractive multifocal IOLs. Methods Using scanning electron microscope (SEM, Inspect F, 5.0 KV, maximum magnification up to 20,000) and atomic force microscope (AFM, Park Systems, XE-100, non-contact, area profile comparison, 10 × 10 µm, 40 × 40 µm), the surface quality of the following diffractive IOLs was studied: the AcrySof IQ PanOptix (Alcon, USA), the AT LARA 829MP (Carl Zeiss Meditec, Germany), and Tecnis Symfony (Johnson&Johnson Vision, USA). The measurements were made over three representative areas (central non-diffractive optic, central diffractive optic, and diffractive step) of each IOL. Roughness profile in terms of mean arithmetic roughness (Ra) and root-mean-squared roughness (Rq) values were obtained and compared statistically. Results In SEM examination, all IOLs showed a smooth optical surface without any irregularities at low magnification. At higher magnification, Tecnis Symfony showed unique highly regular, concentric, and lineate structures in the diffractive optic area which could not be seen in the other studied diffractive IOLs. The differences in the measured Ra and Rq values of the Tecnis Symfony were statistically significant compared to the other models (p < 0.05). Conclusion Various different topographical traits were observed in three diffractive multifocal IOLs. The Ra values of all studied IOLs were within an acceptable range. Tecnis Symfony showed statistically significant higher surface Ra values at both central diffractive optic and diffractive step areas. Furthermore, compared to its counterparts, Tecnis Symfony demonstrated highly ordered, concentric pattern in its diffractive surfaces.

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Does Every Calculation Formula Fit for All Types of Intraocular Lenses? Optimization of Constants for Tecnis ZA9003 and ZCB00 Is Necessary

Medicina ◽

10.3390/medicina57040319 ◽

2021 ◽

Vol 57 (4) ◽

pp. 319

Author(s):

Ivajlo Popov ◽

Veronika Popova ◽

Juraj Sekac ◽

Vladimir Krasnik

Keyword(s):

Prediction Error ◽

Poor Performance ◽

Intraocular Lenses ◽

Power Calculation ◽

Universal Formula ◽

Aspheric Iol ◽

Different Types ◽

The Mean ◽

Clinically Significant ◽

Mean Prediction Error

Background and Objectives: To evaluate the performance of intraocular lenses (IOLs) using power calculation formulas on different types of IOL. Materials and Methods: 120 eyes and four IOL types (BioLine Yellow Accurate Aspheric IOL (i-Medical), TECNIS ZCB00, TECNIS ZA9003 (Johnson & Johnson) (3-piece IOL) and Softec HD (Lenstec)) were analyzed. The performance of Haigis, Barret Universal II and SKR-II formulas were compared between IOL types. The mean prediction error (ME) and mean absolute prediction error (MAE) were analyzed. Results: The overall percentage of eyes predicted within ±0.25 diopters (D) was 40.8% for Barret; 39.2% Haigis and 31.7% for SRK-II. Barret and Haigis had a significantly lower MAE than SRK-II (p < 0.05). The results differed among IOL types. The largest portion of eyes predicted within ±0.25 D was with the Barret formula in ZCB00 (33.3%) and ZA9003 (43.3%). Haigis was the most accurate in Softec HD (50%) and SRK-II in Biolline Yellow IOL (50%). ZCB00 showed a clinically significant hypermetropic ME compared to other IOLs. Conclusions: In general, Barret formulas had the best performance as a universal formula. However, the formula should be chosen according to the type of IOL in order to obtain the best results. Constant optimizations are necessary for the Tecnis IOL ZCB00 and ZA9003, as all of the analyzed formulas achieved a clinically significant poor performance in this type of IOL. ZCB00 also showed a hypermetropic shift in ME in all the formulas.

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