Accommodation measurement in eyes implanted with Tek-Clear Accommodative Intraocular Lens

Studený P. , Dědková B., Farkaš A., Vokrojová M., Siveková D., Břešťák M.

Oční klinika FNKV a 3 LF UK Praha Oční oddělení , Karlovarská krajská nemocnice a.s.

Centrum Fetální medicíny Praha Tek-Clear Accommodative IOL is manufactured by: TEKIA, INC.

www.tekia.com

Ways to restore accommodative ability after cataract surgery

Predictability: intermediate vision Disphotopic phenomena Contrast sensitivity far vision near vision

Multifocal IOL Refractive/diffractive

+ + + + Stability of refraction +

Accommodating IOL

+ + + 0 + -

Tek-Clear Accommodative IOL

 Disc-shaped; excellent stability and centration in capsular bag  5.5 mm optic, 10.4 or 10.2 mm haptic  Biconvex shape  Hydrophilic acrylic  A-constant 118.0

 Thin junctions between optic and haptic part ; lens movement optimization during accommodation (pseudophakic accommodation)  Square-edge design to minimize PCO

Patients, materials and methods

 Number of patients: n=18 (32 eyes)  Average age of patients: 60.6 (28-81)  Follow up time: 3 months at least  Preoperative UCVA: 0.28 (0.05- 0.7)  Preoperative BCVA: 0.65 (0.05-1.0)  Preoperative refraction (SE): 2.125 (0-6)  Cataract  Examination objectives: UCVA, BCVA, accommodative amplitude

Patients, materials and methods

 1 phaco surgeon  Standard cataract surgery, CCI 2.2mm, incision u.12, Infinity vision system, bimanual I/A, PCIOL implantation without OVD

IOL movement in eye

Ultrasound system Vivid7Pro, Probe L12M

Ultrasound examination

Eye accommodation examination

 Push-up test  Defocus  Plusoptix

Push-up test – results

 Subjective method  Optimal correction for long distance  Text is moved towards the patient – he/she notifies when the text becomes blurred

Push-up test – results

 After 7 days  After 1 month  After 3 months 3.92 D (1-5) 3.52 D (1-5) 4.17 D (1-5)

Push-up test – results

16 14 12 10 2 0 8 6 4 1D 1-2D 2-3D above 3D After 7 days After 1 month After 3 months

Defocus method

 Subjective method  Optimal correction for long distance  Patient watches optotypes placed 5m in front of him  Minus lens correction is progressively increased until the image become blurred

Defocus method – results

 After 7 days – 0.79D (- 0.5D -1.25D)  After 1 month – 0.85D ( -0.5D – 1.25D)  After 3 months – 0.87D ( -0.5D – 1.5D)

Plusoptix

 Objective method  Binocular auto-refractometer is placed 1 meter in front of the patient  Fixation target is moved towards the patient  Changes in eye refraction are recorded – refraction difference between short and long distance

Plusoptix – results

 After 7 days – 1.92D ( 0.88 – 3.04)  After 1 month – 2.16D ( 0.89 – 4.18)  After 3 months – 2.2D (1.0 – 3.6)

Plusoptix – results

16 14 12 10 8 6 4 2 0 below 1D 1-2D 2-3D above 3D After 7 days After 1 month After 3 months

Summary

 Excellent accommodation ability of Tek-clear IOL was demonstrated by means of subjective and objective examination of accommodation amplitude at 3 months follow up.

 Anterior optic vault during accommodation was captured using high-frequency ultrasound – this effect explains increase in optical power of lens

Summary

 Longer follow up time is needed  More patients

Thank you for your attention