SPINNING THE WHEEL-STABILITY

OFCOMMONLY USED IOL IN-THE-BAG

DR ARUP BHAUMIKDISHA EYE HOSPITALS AND RESEARCH CENTRE

BARRACKPORE, WEST BEGAL, INDIAarupbhaumik_cal@yahoo.co.in

The author has no financial interest in the subject matter of this poster

Cataract surgery – most important refractive surgery

1. Accurate biometry 2 . Right IOL selection 3. Astigmatically Neutral wound 4. Correction of pre-existing astigmatism 5. etc

Correction of pre existing astigmatism

Toric IOL…….. Best possible answer

Criterion of TORIC IOL

1 Rotational stabilities of IOL within the Bag 2 Excellent Toric optic 3 Precise software or calculator 4 etc

Are all IOL designs suitable platform for Toric optic ?

Aims of this study

To compare the rotational stabilities of commonly used IOL within the bag and to identify best possible IOL design for toric IOL

Materials and Methods

Ten patients of grade III nuclear sclerosis cataract were selected randomly in each group who required IOL of 22D to 24D(to avoid gross disparity of capsular bag size)

Materials and Methods

• Phacoemulsification was done with 2.8 mm clear corneal incision in all the cases.

• In all the cases Healon GV was used for IOL implantation

• After IOL implantation Healon GV was thoroughly washed out.

• Final position of haptic was marked

Materials and Methods

• Now 2ml BSS was taken in 2ml disposable plastic syringe

• BSS was injected forcefully into the anterior chamber and the capsular bag by 26 gauze cannula through main incision.

• New position of haptic was marked and rotation was calculated

Materials and Methods

Video

Materials and Methods

IOL implanted Acrysof Multipiece MA60AC (multipiece hydrophobhic lens) Acrysof IQ SN60WF (single piece hydrophobic with aspheric design) Soflex LI61SE (three piece silicon lens) Tecnis I ZCB00 (single piece hydrophobic lens) Tecnis multipiece ZA9003 (silicon multipiece lens)Akreos Adapt (Single piece hydrophillic lens with plate haptic) SQ RYCF (hydrophillic single piece)

Results

IOL Avg. rotation of IOL within the capsular bag

Acrysof IQ Lens 90

Tecnis I 420

Acrysof multipiece 560

Soflex >3600

Tecnis multipiece >3600

Akreos >3600

RYCF >3600

Conclusion

• In this study no IOL design showed absolute rotational stability within the bag

• Acrysof IQ lens showed more rotational stability than others and it may be the best possible platform for toric IOL in present day scenario.

Thank you