Stability of Capsulorhexis Size and Refraction following Crystalens AT5052SE Implantation with Anter

1
Stability of Capsulorhexis Size and Refraction
following Crystalens AT50/52SE Implantation
with Anterior Capsule Lens Epithelial Cell
Removal

• Jack A. Singer, MD
• Singer Eye Center
• Randolph, Vermont, USA

Consultant to Bausch Lomb Surgical Design
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Study Design

• 100 eyes with crystalens AT50/52SE
• Anterior capsulotomy 6.0 x 6.5-7.0 mm
• Removal of anterior capsule LECs
• Ultrasonic I/A with Free-flow fluidics
  (gravity)(Surgical Design)
• Shepard Capsule Polishers (Momentum Medical)
• Slit lamp photos at 1-3 wks and 4-6 mos
• Manifest refraction at 1-3 wks and 4-6 mos
• No YAG laser treatments prior to 4-6 mos

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Capsulotomy gt optic hinges
AT50SE (Five-0) 6.0 x 7.0 mm
oval capsulotomy
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Capsulotomy gt optic hinges
oval capsulotomy 6.0 x 7.0 mm
AT50SE (crystalens Five-0)
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Anterior Capsule LEC removal

• free-flow fluidics (Surgical Design)

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Anterior Capsule LEC removal

• free-flow fluidics (Surgical Design)

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Anterior Capsule LEC removal

• Ultrasonic I/A, curved, 0.2 mm port
• 5 to 15 ultrasound / Free-flow fluidics

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Anterior Capsule LEC removal
Free flow Ultrasonic I/A
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Anterior Capsule LEC removal

• Titanium curettes for sub-incisional area
• Shepard polishers (Momentum Medical,MomentumMedIn
  c_at_verizon.net)

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Anterior Capsule LEC removal

• Ultrasonic I/A, curved, 0.2 mm port
• 5 to 15 ultrasound / Free-flow (gravity)
• Shepherd polishers (Momentum Medical)

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Crystalens Five-O
8 days
4 weeks
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6 months
1 week
13
OD 1 week
OS 1 week
6 months
5.5 months
14
OD 1 week
OS 1 week
6 months
5.5 months
15
1 week
5.5 months
16
OD 1 week
OS 1 week
7 months
6.5 months
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OD 1 week
OS 1 week
5 months
4.5 months
18
1 wk
OD
OS
2 mos
6 mos
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Refractive Stability
n 100
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Refractive Stability
100 Eyes (sorted by change in SE)
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crystalens Sept 1, 2007 to Sept 30, 2008
Outcomes at the last postoperative visit
Uncorrected Distance
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crystalens Sept 1, 2007 to Sept 30, 2008
Outcomes at the last postoperative visit
Uncorrected Intermediate
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crystalens Sept 1, 2007 to Sept 30, 2008
Outcomes at the last postoperative visit
Uncorrected Near
J1
J1
J2
J3
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crystalens Sept 1, 2007 to Sept 30, 2008
Outcomes at the last postoperative visit
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Conclusions

• Meticulous anterior capsule LEC removal
• Prevents contraction of anterior capsulotomy
• Stable postop refractions with crystalens
• Excellent uncorrected distance, intermediate and
  near vision outcomes with crystalens
• IOL Master AL, Ks
• Optimized Haigis formula

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Muito obrigado por sua atenção
Thank you for your attention
Singer Eye Center Randolph, Vermont,
USA www.SingerEye.com