Capsular bag refilling using a new accommodating intraocular lens

Abstract

Purpose-To describe a new capsular bag refilling procedure using a novel accommodative intraocular lens (IOL). Settings-JinshikaiMedical Foundation Nishi Eye Hospital, 4-14-26 Nakamichi, Higashinari-ku, Osaka 537-0025, Osaka, Japan Methods-A disc-shaped anterior accommodative IOL (AC-IOL) serving both as an optical device and also as a mechanical device to prevent leakage of the injected silicone polymers has been developed. The optic and overall diameters of this foldable silicone IOL are 6 and 9 mm, respectively,. After 3.5 to 4 mm continuous curvilinear capsulorhexis (CCC) is completed, phacoemulsification and aspiration are performed in the usual manner. Then a posteriorly placed AC-IOL with sharp edges, is implanted into the capsular bag that both prevents PCO formation as well as leakage of the injected silicone polymer. A posterior CCC may be considered as an option at this point. Then, an anterior AC-IOL is piggy-backed over the existing IOL and silicone polymers are injected between two IOLs.Results-Experiments in numerous pig cadaver eyes and as well as 10 rabbit eyes, showed minimal to absent silicone leakage. In the eyes without a posterior CCC, two eyes were PCO free and three eyes showed slight to moderate PCO. All 5 eyes with posterior CCC were PCO free 5 to 8 weeks after surgery.Conclusions-This procedure which has the potential to overcome the two persisting problems that plague lens-refilling techniques, namely, leakage of the injectable silicone polymer and capsular opacification may represent a breakthrough in lens-refilling technique. The procedure will soon be tested in primate eyes to confirm the accommodation range achieved. SYNOPSISThe experimental results of a new lens refilling procedure showed that it may solve the two persisting problems, leakage of the injected silicone polymer and capsular opacification, and thus may demonstrate potential clinical application.

The parameters of the porcine eyeball

“…Also, central thickness is less than that of the pig eye [3]. For this reason, the use of the pig eye as an animal model in the development of intraocular lenses is difficult [5].…”

“…The pig eye is an ex vivo animal model often used in vision sciences research because its morphology is similar to the human eye [1][2][3][4][5][6]. The pig eye has been used in neuroretinal studies due to the similarity of the distribution of the retinal layers to that of the human retina [1], and it is also a validated animal model of glaucoma [4].…”

“…The pig eye has been used in neuroretinal studies due to the similarity of the distribution of the retinal layers to that of the human retina [1], and it is also a validated animal model of glaucoma [4]. Moreover, it has been used in cataract surgery research [5], in corneal transplant studies [6,7], and as a model in aberrometry studies [2,3].…”

Pilot study of new focus-shift accommodating intraocular lens

“…13 These critical facts form the basis of lenticular strategies for the restoration of accommodation with focus-shift accommodating IOLs, dual-optic accommodating IOLs, and lens-refilling procedures. 14,15 There are many methods of assessing the performance of accommodating IOLs. Psychophysical tests, including DCNVA and subjective amplitude of accommodation, are frequently used.…”

A numerical model of light adjustable lens

“…An accommodating IOLs attempts to have a similar mechanism of action to the human lens, and is designed to accommodate or adjust to see at multiple distances. There are a number of accommodating IOLs in various stages of clinical trials or early research [6][7][8][9][10][11]. So far, none has been implanted in large numbers of humans.…”