Results of Hydrophobic Acrylic IOL Insertion through Corneal Microincisions Smaller than 2.0 mm
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Results of Hydrophobic Acrylic IOL Insertion
through Corneal Microincisions Smaller than
2.0 mmTomoichiro Ogawa, Takuya Shiba
Hiroshi Tsuneoka
Jikei University School of Medicine, Tokyo, Japan
Authors have no financial interests
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AF-1 iMics1 ( HOYA )• Hydrophobic acrylic intraocular lens (IOL)• Implanted through corneal microincisions
Y-60HY-60HiMics1iMics16mm
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AF-1 iMics1 ( HOYA )• Injector : ISH004(HOYA)• Cartridge : Type-N18 ( HOYA )
oPreferred incision size:Cornea, 2.0 mm; Sclera cornea, 1.8 mm
PurposeTo evaluate the safety and efficacy of
cataract surgery with implantation of the AF-1 iMics1 IOL through a corneal microincision
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Subjects and Method• May - August 2009• Jikei University Hospital• Procedures: 69 eyes
• 1.7-mm ( inner scale ) corneal incision: 47 eyes• 2.0-mm ( inner scale ) corneal incision: 22 eyes
• Operative method• 1.4-mm temporal corneal incision • Bimanual phacoemulsification• Incisions enlarged to 1.7 or 2.0 mm • Implant AF-1 iMics1
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Variables examined• Incision size ( before and after IOL
implantation )• Tsuneoka microincision gauge ( ASICO )
• Increased width of corneal incision after IOL implantation
• Surgery-induced corneal astigmatism ( Cravy method )• 1 month postoperatively
• Operative complications• Postoperative complications
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0.310.22 0.25
0.1
0.2
0.3
0.4
1.9mm 2.2mm Y-60H (2.2mm)
(mm) *
**1.7 mm 2.0 mm
Results
**2008. Ogawa. ESCRS.
2.272.052.09
1.791.5
1.7
1.9
2.1
2.3
pre post pre post
1.7mm 2.0mm
(mm)
Wound width
Increased wound width
P=0.0025Mann-Whitney U-test
*
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Results
0.031
-0.057
0.039
0.580
0.200
-0.1
0.1
0.3
0.5
1.9mm 2.2mm Y-60H(2.2mm)
SA60AT(C)(2.2mm)
SN60WF(C)(2.2mm)
(D)
** ** **
* NSSurgery- induced corneal
astigmatism
*Mann-Whitney U-test
**2008. Ogawa. ESCRS.
1.7mm 2.0mm
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Results 1.7 mm 2.0 mm
Posterior capsulerupture 0 eye/47 1 eye/22Wound
self-healing 100% 100%
1.7 mm 2.0 mmIOL decentration 0% 0%
Cysticmacula edema 0% 0%
Woundself-healing 100% 100%
Operative complications
Post- operative
complications
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DiscussionsPosterior capsule rupture
Tip of cartridge is too deep in anterior chamber and too close to posterior capsule
Insertion of cartridge
Tip of cartridge
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Tacking tips of both forward and back hapticsО Full length of IOL is greater than that of other foldable
1-piece IOLsAF-1 iMics1 is stiffer
AF-1 iMics1 SN60WF
Full length is greater
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IOL is released near posterior capsule
Posterior capsule ruptureIOL implantation
IOL goes through posterior capsule
Posterior capsule ruptures
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ConclusionAF-1 iMics1 ( HOYA )
• Implanted through corneal incision < 2.0 mm• Little surgery-induced astigmatism • Wound self-healing• Carefully position tip of cartridge