By Cheryl Guttman Krader; Reviewed by Sam Masket, MD
An in-the-bag intraocular lens (IOL) with an optic that is fixated by the anterior capsule appears to be achieving its goal of preventing negative dysphotopsia. The modifications to the original design also show promise for eliminating problems of capsule block and iris-optic capture.
The optic features a groove on its anterior surface that allows for a lip of the optic to override the anterior capsulotomy (See Figure 1). Version 2 of the IOL incorporated fenestrations that were included to both prevent capsule block, allowing a route for fluid to escape from the capsular bag and to provide fixation holes that would enable surgeons to easily capture the optic in the capsulotomy.
The third version retains the fenestrations and features a larger, 6.4-mm optic as an attempt to avoid iris-optic capture.
Samuel Masket, MD, reported that 100 eyes undergoing routine cataract surgery were implanted with the anti-dysphotopic IOL. The series includes 39 eyes implanted with version 1, 49 eyes receiving version 2, and 13 eyes implanted with version 3.
None of the eyes receiving the IOL as a primary implant develop negative dysphotopsia, and the problem resolved in 2 eyes that received the novel IOL in an exchange procedure. Among the 13 eyes implanted with version 3, there have been no cases of capsule block or iris/optic capture.
“We believe we have adequate proof-of-the-design concept for avoiding negative dysphotopsia,” said Dr. Masket, private practice, Advanced Vision Care, Los Angeles; clinical professor of ophthalmology, David Geffen School of Medicine, University of California, Los Angeles.
“We have also established an A constant, and our current plan is to implant another 30 to 50 eyes with the third model,” Dr. Masket said. “If we do not encounter problems, we will release the lens for general use in Europe.”