Moderator
Sherleen H. Chen, MD, FACS
Panelists
Ryan G. Smith, MD
Roberto Zaldivar Sr., MD
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Alex Hacopian, MD
Co-Authors
Phillip Brunson OD
Purpose
To evaluate the 3-month postoperative outcomes after bilateral implantation of the TECNIS Odyssey intraocular lens (IOL).
Methods
This study was a single center, ambispective study of visual outcomes after successful bilateral cataract surgery and TECNIS Odyssey implantation. A total of 80 eyes of 40 subjects at one site were targeted. Subjects were assessed at least 3 months postoperatively at a single visit. Clinical evaluations included measurement of visual acuities at distance, intermediate, and near, and administration of the assessment of intraocular lens implant symptoms (AIOLIS) and ocular surface disease index (OSDI) questionnaires.
Results
To date, a total of 19 patients have completed the study. Binocular mean uncorrected visual acuities at 6m, 66cm, 40cm, and 33cm were -0.05 � 0.06, 0.02 � 0.12, 0.04 � 0.10, and -0.02 � 0.07 logMAR, respectively. The most commonly reported dysphotopsias were glare at night, halos, and rings, with 26%, 21%, and 16% of subjects experiencing them �Always�, respectively. However, only 11%, 0%, and 5% of subjects were �Extremely� bothered by glare at night, halos, and rings, respectively. In addition, 85% of subjects reported needing glasses �Not at all� or �A little of the time�, and 90% of subjects rated their overall vision as �Excellent� or �Very good.�
Conclusion
Interim results suggest excellent visual outcomes at distance, intermediate, and near, minimal bothersomeness of dysphotopsias, and high spectacle independence with bilateral Odyssey implantation.
Presenting Author
Guy Kleinmann, MD
Co-Authors
Ayat Qassoom MD
Purpose
To evaluate the uveal and capsular biocompatibility of a new material for intraocular lens (IOL) fabrication, the Eyedeal� (Xi'an Eyedeal Medical Technology, Inc. Ltd, Shaanxi, China), in comparison to a commercial reference IOL in a rabbit model.
Methods
Bilateral phacoemulsification was performed in 10 rabbits; 1 eye was implanted with the test IOL, the Eyedeal�, and the other eye was implanted with the Reference IOL, the AcrySof� SA60AT (Alcon, Fort Worth, USA). Slit-lamp examinations were performed at postoperative weeks 1 and 6. The rabbits were euthanized at six weeks postoperatively, and the eyes were enucleated. After gross examination with the Miyake-Apple view, all eyes were sectioned and processed for histopathologic examination.
Results
No difference was found in the uveal and capsular biocompatibility of the study and control IOLs in the biomicroscopy, Miyake-Apple posterior view, and histopathologic examination. A trend toward lower incidence and mean group severity of Soemmerring's ring was found in the Eyedeal� IOL group.
Conclusion
The Eyedeal� IOL was found non-inferior to the Reference IOL, the AcrySof� SA60AT. Both groups demonstrated the typical, expected ocular reactions of PCO and Soemmerring's ring after IOL implantation in rabbit eyes.
Presenting Author
Marcela Barros, MD
Co-Authors
Roberta Matschinske van den Berg MD, Stephen Klyce PhD, Karl Stonecipher MD, Sarah DeVaro MD, Karolinne Rocha MD, PhD
Purpose
To evaluate refractive outcomes, subjective (DoFs) and objective depth of focus (DoFo) based on through-focus augmented VSOTF using ray-tracing aberrometry and the eye's wavefront analysis in eyes with aberrated corneas that underwent cataract surgery with a small aperture IC-8 Apthera IOL compared with a monofocal IOL.
Methods
This prospective observational study included 34 eyes with aberrated corneas undergoing cataract surgery and implantation of the IC-8 Apthera IOL (B&L) and a monofocal IOL. Postoperative assessments included refractive outcomes, DoFs curves, raytracing DoFo aberrometry-derived visual Strehl optical transfer function (VSOTF), and wavefront analysis (iTrace,Tracey technologies) in both groups. Corneal higher-order aberrations (HOAs) at 6-, 4-, and 2 mm corneal plane aperture sizes were measured pre and post-operatively using Pentacam Wave (Oculus). Visions were expressed as LogMAR.
Results
The mean post-operative UDVA was 0.19 � 0.17, DCVA 0.09 � 0.10, DCIVA was 0.10 � 0.12 and DCNVA was 0.13 � 0.17 for the small aperture group. For the monofocal group UDVA was 0.10 � 0.09, DCVA 0.05 � 0.17, DCIVA was 0.25 � 0.14 and DCNVA was 0.32 � 0.17. The IC-8 group showed statistically significant better visual acuity in myopic defocus compared to the monofocal group p < 0.02. When assessing total ocular HOAs after surgery, the small aperture IOL group revealed significantly improved total aberrations compared to the monofocal group. Total RMS for the IC-8 group was 0.13 � 0.07 �m versus 0.5 � 0.36 �m for the monofocal group (p < 0.002).
Conclusion
Depth of focus achieved with small aperture optics was statistically significant better than the monofocal group in patients with aberrated corneasNear and intermediate visual acuity with the IC-8 were 3 to 4 lines better than with the monofocal IOL.
Presenting Author
Panos Gartaganis, MD, BSc, PhD
Co-Authors
Panagiota Natsi BSc, PhD, Sotirios Gartaganis MD, PhD, Labrini Sygellou BSc, PhD, Menelaos Kanakis MD, Petros Koutsoukos BSc, PhD
Purpose
In the present work we present the results of the investigation of the development of graphene coatings on hydrophilic IOLs and their subsequent performance with respect to calcification opacification.
Methods
Hydrophilic IOLs with water content of 18%-26% by weight, were coated with graphene oxide (GO) by equilibration with GO suspensions 1x10-4 to 20x10-4 % w/v. Equilibration of the IOLs with the GO suspensions lasted for 5 days at constant temperature, 37�C. Past equilibration, IOLs were examined by scanning electron microscopy (SEM) and other physicochemical methods as Raman and XPS spectroscopy.
Results
PHEMA IOLs coated with GO by equilibration with GO suspensions favored HAP formation in supersaturated solutions proportionally to the GO concentration in the equilibration suspension. GO coatings rendered IOL surfaces more hydrophilic, facilitating mineralization. The interactions between the -COOH groups of GO with Ca2+ in the calcifying Simulated Aqueous Humor overcame the nucleation barrier, promoting crystal growth. Chemical reduction of GO with phenyl hydrazine (rGO) at room temperature eliminated mostly the -COOH groups, rendering rGO coated IOLs hydrophobic. rGO coated PHEMA IOLs did not induce HAP crystal growth.
Conclusion
The calcification potential of hydrophilic PHEMA IOLs depends on their hydrophilic character and -OH groups that form complexes with Ca2+ ions, promoting HAP crystal growth on GO-coated IOLs. In contrast, rGO-coated IOLs failed to calcify, indicating that the presence of ionizable groups is crucial for the calcification process.
Presenting Author
Manorama S Baheti, MS
Co-Authors
Nivean Madhivanan MS, Sridhar Baratan MS, MBA
Purpose
To compare the visual acuity, defocus curve,contrast sensitivity and spectacle independence in patients with implantation of 4 different types of IOLs.
Methods
The study included the patients who underwent uniocular cataract surgery with implantation of one of the following IOLs: AcrivaBB (Monofocal), AcriDIFF (Multifocal), AT LISA tri family ( Trifocal),Supraphob Infocus (EDOF).Results reported in this study refers to the 3rd month post op review.
Results
The study compared 120 patients. All the 4 IOLs provided a good distance visual acuity, with the multifocal providing a good near vision, trifocal and EDOF providing the best intermediate vision.The EDOF showed a smoother profile along the entire defocus curve.The monofocal and EDOF had a good contrast sensitivity. The trifocala and EDOF had a better spectacle independence.
Conclusion
Hence depending on the patients lifestyle requirement an appropriate IOL can be recommended using this study.
Presenting Author
Daniel A Black, MD
Purpose
The purpose of this study is to evaluate the effect of post-operative refractive errors in simulated uncorrected distance vision and dysphotopsias of a refractive extended depth of focus (EDF) IOL. The new refractive extended depth of focus IOL has not been yet approved by the FDA in the US
Methods
Monocular distance visual acuity (VA) was simulated using 46 computer eye models with anterior cornea and axial length of a real cataract population. Simulations were performed with the best distance correction and under different levels of defocus and astigmatism. Additionally, dysphotopsias were evaluated using an average eye model and a central glare source under different levels of defocus. Simulations were performed for a refractive EDF IOL, model ZEN00V, and compared to that of a diffractive EDF IOL, model ZXR00, a multifocal IOL, model ZLB00, and two monofocal IOLs, models ZCB00 and ICB00
Results
Monocular uncorrected distance VA with �0.5D of defocus was 0.10 logMAR or better for more than 90% of the eyes implanted with the refractive EDF IOL and the monofocal IOLs and below 20% for the multifocal IOL. Simulations did not show differences between the refractive and diffractive EDF IOLs in the presence of hyperopia and 24% in the presence of myopia with the refractive EDF IOL. All IOLs except the multifocal IOL provided similar results with 0.75D cylinder. Simulations showed that the dysphotopsia profile of the refractive EDF IOL was comparable to that of the monofocal IOLs within �0.5D of defocus and better than that of the diffractive EDF IOL and the multifocal IOL
Conclusion
Computer simulations in realistic eye models show high tolerance to defocus and astigmatism of the refractive EDF IOL, model ZEN00V, providing good uncorrected distance VA and low levels of dysphotopsia comparable to that of monofocal IOLs and better than the multifocal and the diffractive EDF IOLs
Presenting Author
Larissa Gouvea, MD
Co-Authors
Karolinne Rocha MD, PhD, Marcela Barros MD, Raman Bedi MD
Purpose
To compare refractive outcomes, in-vivo wavefront analysis and depth of focus curves between a standard monofocal aberration free intraocular lens (IOL) and a novel monofocal IOL with higher-order aspheric coefficients and controlled curvature change.
Methods
This retrospective observational study included healthy eyes undergoing routine cataract extraction and placement of either a standard aberration free IOL (Envista, Bausch&Lomb) or a novel monofocal IOL that employs higher-order aspheric coefficients on its posterior surface (Envista Aspire, Bausch & Lomb). Natural pupil size and corneal asphericity were measured preoperatively using Scheimpflug tomography. Manifest refraction spherical equivalent (MRSE), corrected and uncorrected distance visual acuity (CDVA, UDVA), depth of focus curves, and spherical aberrations were measured 1-3 months postoperatively. Higher-order aberrations were measured using a ray-tracing aberrometer.
Results
The study included 29 eyes implanted with enVista Aspire IOL and 26 eyes implanted with the enVista IOL. Mean UDVA was statistically significantly better in the Aspire group. Mean CDVA was comparable between the groups. Defocus curve performance showed better mean monocular visual acuity at the intermediate range in the Aspire group. The mean MRSE was close to emmetropia in the Aspire group and slightly myopic in the enVista group. A subgroup analysis was conducted on eyes with postop MRSE within �0.25 D. Even in this subset of eyes, mean UDVA trended to be better in the Aspire group. Mean internal and total coma and spherical aberrations were lower and closer to zero in the Aspire group.
Conclusion
The new enhanced aspheric neutral monofocal IOL demonstrated superior near and intermediate and near visual acuity compared to the standard monofocal IOL of the same platform. Internal and total higher order aberrations were close to zero in both groups
Presenting Author
Andre Messias, PhD
Co-Authors
Karl Boden PhD, Philip Wakili PhD, Peter Szurman PhD
Purpose
To describe refractive outcomes in combined phacovitrectomy using a new 7.0 mm intraocular lens (IOL) - Aspira-Axa, compared with a standard 6.0 mm optic IOL - Sensar One.
Methods
A prospective, open-label clinical trial was conducted involving patients undergoing combined phacoemulsification and pars plana vitrectomy, who were randomly assigned to receive either the Aspira-Axa or Sensar One IOL implant. Tamponade options included balanced salt solution (BSS), air, SF6 at 20%, or C2F6 at 15%. IOL selection was based on measurements from the IOLMaster 700, utilizing the Barrett, Haigis, Holladay, and SRK/T formulas. Pre- and post-operative anterior chamber depth, IOL size, and position were assessed using the Anterion OCT (Heidelberg Engineering).
Results
The study included 102 consecutive patients (Aspira: n=54; Sensar: n=48). A statistically significant postoperative myopic shift (PMS) was observed with all biometric formulas for both lenses. The greatest PMS was found with Aspira and the Haigis formula (-0.33 � 0.04 D), while the smallest was with Aspira and the Holladay formula (-0.19 � 0.03 D). Tamponade did not significantly impact PMS for any formula or lens. The change in ACD between pre- and postoperative measurements was 1.5 � 0.3 mm for Aspira and 1.7 � 0.2 mm for Sensar (p < 0.001), indicating that Aspira is positioned 0.2 mm closer to the cornea compared to Sensar.
Conclusion
Combined phaco-vitrectomy results in a significant PMS for both Aspira and Sensar, regardless of tamponade type. Aspira shows less postoperative ACD enlargement, which may explain the greater PMS observed with ACD-based formulas (Haigis and Barrett).
Presenting Author
Alice T. Epitropoulos, MD, FACS, ABO
Purpose
Patients with large pupils tend to experience more glare and halos after cataract surgery. This study aimed to evaluate the relationship between preoperative photopic and mesopic pupil size and the frequency, severity, and bothersomeness of glare and halos in patients implanted with a novel full range of vision (FROV) IOL.
Methods
This study included pooled data from 2 clinical trials of FROV IOL implantation (enVista Envy, Bausch and Lomb). The Envy IOL optics are designed with small and smooth diffractive steps, which reduce in height towards the periphery of the lens, resulting in a change in the energy balance. This asymmetric energy distribution makes the IOL distance dominant. As such, the energy focused on intermediate and near foci decreases as the pupil size increases. All patients completed a Quality of Vision questionnaire, which included questions on the frequency, severity, and bothersomeness of glare and halo . A logistic regression model assessed the relationship between pupil size and glare and halos.
Results
No statistically significant relationship was observed between pupil size and the frequency, severity, and bothersomeness of glare and halos (all p>0.05). The logistic regression model showed that the risk of reporting a severe response to the frequency, severity, and bothersomeness of glare was not affected by pupil size (Photopic pupil: odds ratio (OR) =0.66, p=0.1595; mesopic pupil: OR =0.92, p=0.7389). Likewise, the risk of reporting severe response to the frequency, severity, and bothersomeness of halos was not statistically significant (Photopic pupil: OR =1.3, p=0.0851; mesopic pupil: OR =1.3, p=0.0737).
Conclusion
This study showed that pupil size has little or no effect on the frequency, severity, and bothersomeness of glare and halos following envista Envy FROV IOL implantation, indicating good tolerance of the novel FROV IOL to the photic phenomena.
To log in, click the teal "Login" button in the upper right-hand corner of this page. If you are logged in but still do not have access, please check your 2025 Annual Meeting registration.
