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Clinico-pathological results of optical quality with different acrylic materials

Clinico-pathological results of optical quality with different acrylic materials. Mayank A. Nanavaty, DO, MRCOphth, MRCS(Ed) David J. Spalton, FRCP, FRCS, FRCOphth James F. Boyce, PhD Thomas J. T. P. Van den berg, PhD . St. Thomas’ Hospital, London.

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Clinico-pathological results of optical quality with different acrylic materials

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  1. Clinico-pathological results of optical quality with different acrylic materials Mayank A. Nanavaty, DO, MRCOphth, MRCS(Ed) David J. Spalton, FRCP, FRCS, FRCOphth James F. Boyce, PhD Thomas J. T. P. Van den berg, PhD St. Thomas’ Hospital, London None of the authors have any financial or proprietary interest

  2. Introduction • Optical quality of vision is dependent on aberrations, PSF, MTF and ocular scatterapart from visual acuity. • There is paucity of information on influence of IOL material on optical quality • One published study objectively quantifying the relationship between IOL material and ocular scatter Tanaka et al. Limitation of Scheimpflug videophotography system in quantifying posterior capsule opacification after intraocular lens implantation. Am J Ophthalmol 2004 Apr;137(4):732-5.

  3. Aim To analyze the effect of IOL material on optical quality in eyes with clear posterior capsules using the asymmetric double pass technique with Optical Quality Analysis System (OQAS II)

  4. Methods • Retrospective, non-randomized, observational study • Patients with clear posterior capsule were recruited from the follow up of two different ongoing prospective, randomized fellow eye controlled studies comparing • Hydrophilic - AcriSmart 36A & Akreos MI60 • Hydrophobic - AcrySof IQ & AcrySof Natural • Single surgeon with standardized surgical technique

  5. Eyes with clear capsule in central 4mm zone on POCOman analysis of digital retro-illumination images were recruited Hydrophilic IOLs Akreos MI60 AcriSmart 36A AcrySof IQ AcrySof Natural Hydrophobic IOLs

  6. Methods • Data of: • 100% & 9% LogMAR BCVA • Entire eye aberrations at 4mm scan size • 50% & 10% PSF, MTFand Strehl ratio after correcting LOA • was extracted for these eyes with clear posterior capsules • Two 20D IOLs of each IOL type was sent for in-vitro analysis of light scatter

  7. Results • 160 eyes of 80 patients were screened • 71 eyes of 46 patients had clear capsules • 58 were white Caucasians, 9 Afro-Caribbean, 2 Indians, 2 Mongolians • No significant difference in aberrations at 4 mm scan size except Zernicke’s polynomial 4 (defocus)

  8. Best corrected visual acuity p = 0.000 p = 0.127 Hydrophilic Acrylic Hydrophobic Acrylic

  9. OQAS II measurements PSF measurements Optical Quality analysis system (OQAS II) p = 0.005 p = 0.008 Measurements done after correcting sphere and cylinder Hydrophilic Acrylic Hydrophobic Acrylic There was no significant difference in MTF and Strehl ratio between to the two IOL groups

  10. In-vitro assessment of scatter Although in-vitro scatter levels are low with acrylicIOLs, hydrophilic acrylic IOLs have more scatter than hydrophobic acrylic IOLs

  11. Conclusion • IOL material has no effect on 100% BCVA, entire eye aberrations, MTF and Strehl ratio • Hydrophilic Acrylic IOLs have reduced 9% LogMAR BCVA • Ocular scatter is more with hydrophilic Acrylic IOLs • This may be because of increased opalescence of the hydrophilic acrylic material due to more water content

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