Implantation simple with two-piece Clamshell accommodating IOL

The Clamshell dynamically accommodating IOL has been shown to be both safe and effective as a two-piece device, whose components are locked together prior to implantation, according to Keiki Mehta, MD, of the Mehta International Eye Institute, Bombay, India.

The IOL comprises a posterior plate and an anterior ring. When the parts are locked together, the IOL can be injected into the anterior chamber easily through a standard 2.8-mm clear corneal incision. The parts of the IOL lock securely and do not separate. When inserted he advised that the ring be slipped under the anterior ring of the capsule, which is easily done with use of a viscoelastic agent.

Dr. Mehta has implanted the IOL in 214 cases with follow-up out to 36 months. He reported that B-scan ultrasonography showed the movement of the IOL within the eye.

The limitations of this lens are the rhexis must be perfect and all cortical material must be completely removed to prevent gravitation inside the bag, he said. Complications include an occasional rhexis tear and residual cortical material, Dr. Mehta added. About 12.7% of the lenses have been explanted.

"The implantation is simple to perform, the IOL works well, and surgeon requires no special training. Evaluation out to 36 months after implantation indicates that the IOL is functioning well. The patients are achieving 20/30 or better vision and patient satisfaction is high. We believe that this is the lens of the future," he said.