ROLLABLE IOLS FOR MICROPHACO PRESENT DAY STATUS DR'G'L'ARUN KUMAR

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New Ultrasmart Foldable Intraocular Lens For
Bimanual Phaco Surgeries. A Long Term Follow-Up


Dr.G.L.Arun Kumar, MS,DNB,FRCS Dr.G.Seethapathy,
MS Dr.R.Kalaiselvan, DO

APPASAMY
EYE HOSPITAL MEDICARE
CENTRE, CHENNAI, INDIA
The author and coauthors are paid consultants
of Appasamy Associates,INDIA
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AIM

• To analyze the Ultrasmart Foldable
  Intraocular Lens(IOL) for Bimanual
  Phacoemulsification Surgeries - its optical
  quality (unaided visual acuity for distance and
  near and contrast sensitivity), long term
  centration and stability of the IOL and the
  amplitude of accommodation.

MATERIALS AND METHODS

• Prospective randomized study.
• 30 patients with bilateral cataracts (60 eyes)
  of grade I to grade III were chosen for this
  study.
• The second eye of these patients were operated
  within a time interval of 3 months.
• Males Females 14 16. The minimum age was
  54 years and the maximum age was 75 years with a
  mean age of 65 years.

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MATERIALS AND METHODS
EXCLUSION CRITERIA

• Systemic illness eg Diabetes mellitus,
  Hypertension.
• Macular pathologies eg ARMD,Macular hole etc.
• Pre-operative astigmatism greater than 0.50
  diopters.
• Myopes (axial length gt 24 mm).

• All these eyes underwent temporal Bimanual (2
  incisions, each 1.4mm) Phacoemulsification.
• Anterior Capsulorhexis of 5.00 to 5.50mm was
  made.
• After emulsification of the nucleus the
  Ultrasmart Foldable IOL was implanted through a
  separate 1.8 mm incision.
• Postoperatively the patients were assessed on
  the 1st post-operative day, after 1 week, after 1
  month, after 3 months and were followed upto 18
  months.

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ULTRASMART FOLDABLE IOL
This Intraocular Lens has not been approved by
U.S.Food and Drug Administration(FDA)
Optic Diameter 6.0 mm Overall Length
10.50 To 11.00 mm Central Thickness 450
microns Edge Thickness 150
microns Hydrophilic Acrylic 26 Water
content Incision Size 1.8 mm
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Patients with Ultrasmart Foldable IOL implanted
bilaterally following first eye surgery (30 Eyes)
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Patients with Ultrasmart Foldable IOL implanted
bilaterally following the second eye surgery (30
Patients)
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FIRST DAY POST-OP
6 MONTHS POST-OP
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1 YEAR POST-OP
18 MONTHS POST-OP
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RESULTS

• 12 patients were able to read N8-N6 unaided
  post-operatively.
• 18 patients required a near vision addition of
  1.50 to 2.00 diopters for continuous reading
  and very fine work.
• Otherwise they were comfortable for most of the
  distances without the need of glasses.
• 2 patients developed Posterior Capsular
  Opacification in one eye each on the 3rd month
  visit for which Nd YAG Capsulotomy was done.

CONTRAST SENSITIVITY
CSO Chart Projector (With Best Corrected Visual
Acuity) Ultrasmart Foldable IOL 10 -
20 PMMA IOL 40 -
50 Hydrophilic Foldable IOL 40 - 50

AMPLITUDE OF ACCOMODATION
Measured by Streak Retinoscopy (for distance and
for near) - 1.7 to 1.8 diopters.

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PSEUDO ACCOMODATION

• - Forward vaulting of the IOL with ciliary
  muscle contraction (Plate design as well as the
  thin profile of the IOL)
• - Aspheric profile of the IOL due to its
  refractive thin lens optic
• - Blur tolerance as a result of alteration in
  the aberration profile of the operated eye
• - Small incisions afforded by Bimanual Phaco

CONCLUSIONS

• The visual rehabilitation of the patients was
  excellent on the first post-operative day. The
  centration and stability of the Ultrasmart
  Foldable IOLs was found to be excellent.
• - The contrast sensitivity was found to be
  excellent. This was mainly due to the thinness of
  the IOL and the aspherical anterior surface.

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CONCLUSIONS

• - It can be implanted not only following
  Bimanual Phaco surgeries but also after coaxial
  phacoemulsification surgeries.
• - The Ultrasmart Foldable IOL promises to be
  the IOL of the future with all its optical
  qualities by providing a excellent functional
  vision without compromising on the contrast
  sensitivity.

THANK YOU