MATRIX AURIUM – THE FIRST IOL with UV and BLUE-VIOLET ABSORBTION THAT SHOWS

1. MATRIX AURIUM – THE FIRST IOLwith UV and BLUE-VIOLET ABSORBTION THAT SHOWS PHOTOCHROMIC PROPERTIES: preliminary results.Dr. Bordeianu CD – Ploiesti

2. Motto 1: "Dubito - ergo cogito, cogito - ergo sum" Descartes Motto 2: If God exists and you are a believeryou gain everything. If God does not exist and you believe - you have nothing to lose. If God exists and you are not a believer you lose everything The whole paper, starting with the balance in the background urges you to think.André Maurois

3. Why these mottos fit to any paper on blue-violet absorbing IOLs? Because these lenses have so recently entered the market, while the protective effect against macular degeneration needs decades to be proven. Until then, the wisest attitude is to respect the second motto while we persist doubting according to the first motto: if the theory is true and we use blue-violet absorbing IOL, we offer to our patients maximal protection against macular degeneration; if the theory is not true and we use these lenses, our patients will have nothing to lose; IF THE THEORY IS TRUE AND WE DON'T USE SUCH LENSES OUR PATIENTS HAVE ONLY TO LOSE. .

4. WHAT DOES THE THEORY SAY? I: SOME WAVE LENGTHS MAY HARM. 1. Besides UV radiation, blue-violet light may have a deleterious effect upon macula, favoring macular degeneration. 2. Natural ageing lens blocks these radiations, but classic IOLs don't. As consequence, almost every IOL producer has introduced blue or blue-violet blocking light implants.

5. II: THE BIOLOGIC CLOCK NEEDS DAILY ADJUSTMENT. The blue light is responsible with this adjustment. Without resetting it, various psychiatric disturbances may appear on predisposed subjects: diminished resistance to stress - sleep disturbances - disharmonic psychosis - suicide . The blue light is necessary. Permanently blocking it may harm and create a new pathology. .

6. III. THE NIGHT VISION IS ALTERED BY AGEING PROCESS twice as fast as the day vision. Any light absorbing filter will alter an already altered retinal function. Fact: night driving in rain is more difficult with permanently yellow lenses .

7. WHAT IS THE CONSEQUENCE OF ALL THESE? It's wise to inform our patients that: 1. Blue-violet light may harm and it's safer to use Blue-violet absorbing IOLs. 2. Blue-violet light is necessary for our biologic clock adjustment. 3. Blue-violet absorbing IOLs could accentuate the adaptation difficulties in conditions of dim illumination. It is wise to leave them the burden of choice. If not, we could be considered guilty, because without a complete and correctly information we did not obtained an informed consent.

8. 4. There is an implant that fulfills all recommendations: "MATRIX AURIUM " - Medennium Inc. USA: acrylic hydrophobe containing chromophores that absorb - UV light (permanently) - blue-violet light (with a photochromic interval of 10 -30 seconds). WITH THIS IMPLANT: DARKNESS: 10-30 SECONDS IN UV LIGHT: 1. The daily adjustment of our biologic clock is possible, 2. Macula will be protected against harmful radiations.

9. MATERIAL AND METHODS A prospective study, one surgeon . 40 patients, 14 men - 26 women, 35-84 years. Phakomachine: - CataRhex PRO - Oertli, Switzerland, Technique: - 32 c.: diathermiccapsulorhexis, 8 c.: tractional CCC - cold microincisionphako(1.2mm) or co-axial MICS (1.6 mm) isometric phakoemulsification (tunnel, crack and conquer) techniqueBordeianu CD, RAO Iasi - 2003; ESCRS Congress Paris 2004. PhillipeSourdille: "no motion phakoemulsification"- SFO - Paris 2007 Cataract hardness: I - 1 case, II - 10, III - 19, IV - 14, IV+ - 9. Phako: 34 cases,with effective phako time: 2-5 – 18-47 seconds. The IOL was injected through 2.8 mm incision (Ophtec OD501 cartridge) ECCE with 2 instruments (7.5-8.5 mm) in 6 cases.

10. RESULTS after 3-10 months: 1. Good concordance with biometry data: aiming to -0.5 – -0.75 D at biometry, a dispersion from + 0.5 - -1.25D was obtained (m=-0.47D). UCVA = 5/5 - 5/10 = 80%; 5/15-5/30 = 12.5%; 5/40 - 5/60 = 7.5%. satisfactory UCVA for distance and semi-distance (J3 - J5). BCVA = 5/5 - 5/10 = 92.5%, 3 cases with ARMD or macular traumatic scar. Comfortable reading needed additional correction of +2 - +3D. 2. Perfect tolerance, no inflammatory reaction; 3. Friendly behaviour to YAG laser (3 cases: opacified PC since surgery); 4. Photophobia: In 17 cases, the other eye had already been implanted with classic IOL: no difference between the two eyes was spontaneously remarqued; after 10 seconds in full sun, 11 of them declared that Aurium eye is less photophobic.

11. CONCLUSIONS. 1. After 3-10 months, Matrix Aurium IOL is perfectly tolerated. Photochromic properties stable up to 23 years in an ISO 11979-5 study in accelerated test conditions for photostability. 2. Matrix AuriumIOL protects the macula against blue-violet radiation only when it needs protection. 3. In sunlight it protects, while yellow colour brings sharper vision.

12. 4. In medium light, it protects without hindering: - our biologic clock can be adjusted every morning - colour perception is not modified. 5. In dim light - no supplementary adaptation difficulties. From all these points of view, Matrix Aurium is superior to any other blue-violet absorbing IOL.

13. If we have accepted to implant Alcon Natural IOL - based on an unproven theory, - if a new theory appears, seems to hold water and produced an IOL, - if the new IOL is well tolerated, and price competitive one, - if it seems to be superior to Alcon Natural, because it is the only to protect without hindering, I see no medical reason to refuse trying Matrix Aurium IOL.