Mauricio%20Miranda%20MD,%20Luis%20Izquierdo%20Jr.%20MD

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Accommodating IOL Implantation Experience

• Mauricio Miranda MD, Luis Izquierdo Jr. MD

Authors have no financial interest
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Purpose

• To evaluate the accommodative range of the NuLens
  AIOL in 5 patients and to study its behavior and
  biomechanics in 5 eyes implanted by one
  experience surgeon (L. Izquierdo) at Oftalmosalud
  Eye Institute Lima-Peru.

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Material and Methods

• Material and Methods 5 eyes of patients range
  between 27 and 65 years old, 4 women and 1 men,
  with normal anterior chamber and no corneal
  pathology who had impaired vision in one eye due
  to amblyopia (4 high myops and 1 cataract
  patient).

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Material and Methods

• Pre-surgical examination Biomicroscopy, IOL
  master, UBM, Visante-OCT were done to all
  patients.
• A perfect 5.5 mm continuous circular
  capsulorrhexis normal Phacoemulsification was
  performed the NuLens AIOL was implanted in 2
  steps. First the Base of the Lens and secondly,
  the Haptic of the IOL.
• An endoscopic revision of the incision of the
  zonule was examined by Dr. Joshua Ben-nun at the
  operating room.

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Results

• Pre-Implantation values sphere (media -5.60),
  cylinder (media -2.55), axis (media 52.00),
  LogMar BCVA (media 0.6520) and near VA at 40cm
  (media 12.25).
• Post-Implantation values sphere (media -0.45),
  cylinder (media -2.50), axis (media 73.80),
  LogMar BCVA (0.7380) and near VA at 40cm (media
  14.50).
• Accommodative range 6.00 Diopters. p0.0000 (See
  Table).

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Results
N Sphere Media
3 5 -4.6500
-3 5 2.0000
Results of accomodative range of NULENS (AIOL)
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Zonule implatation of the haptic of the NULENS
AIOL
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5.5 mm CCC of the NULENS two pieces AIOL
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Conclusions

• This is a new technology which seems to be an
  alternative in the future to achieve more
  accommodative range and therefore a better
  quality of vision. We are still working in
  adjusting the power of the AIOL and its size to
  improve its biomechanics inside of the eye.
• NuLens demonstrated to have an accommodative
  range of 6 Diopters in all patients studied so
  far and a central positioning without damaging
  any anterior and posterior chamber structures of
  the eye.

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Conclusions

• We are demonstrating our preliminary results in 5
  patients after 15 days average after AIOL
  implantation.
• Far VA has demonstrated a significant improvement
  even though 4 out of the 5 patients with
  amblyopia were high myopic (N5). At the moment,
  near VA has not been determined accurately due to
  cyclopegic status of the 5 patients.

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References

• Ben-nun, J. MD Alió, j. MD, PHD. Overview of
  the NuLen Accommodating IOL CATARACT
  REFRACTIVE SURGERY TODAY EUROPE JAN/FEB 2008
  20-21
• Menapace, R., Findl, O., Kriechbaum K.,
  Leydolt-Koeppl, Ch. Accommodating intraocular
  lenses a critical review of present and future
  concepts. GRAEFES ARCH CLIN EXP OPHTHALMOL.
  2007. vol 245 473489
• NuLens real accommodative IOL homes in on
  billion-dollar presbyopic market CLINICAS
  MEDTECH VENTURES. 30 March 2007. Issue No 8 13
• Chang, D. MD.Mastering Refractive IOLs The Art
  and Science SLACK Incorporated. 2008