Comparison of two acrylic intraocular lenses with different haptic designs in patients with combined phacoemulsification and pars plana vitrectomy

Abstract

Purpose The intra-and postoperative characteristics of two foldable single-piece intraocular lenses (IOL) with identical hydrophilic acrylic material, but different haptic designs (Akreos Adapt s and Akreos Fit s ), were compared in combined phacoemulsification and pars plana vitrectomy (PPV). Methods This was a prospective, randomized study in patients with simultaneous cataract and vitreoretinal surgery. Group A (n ¼ 47 patients) included implantation of Akreos Fit s IOL (two-point haptic) and group B (n ¼ 46 patients) implantation of Akreos Adapt s IOL (four-point haptic). All intraoperative modifications of small-incision phacoemulsification and three-port PPV and IOL implantation and centration were documented. At 1 and 2 days and 6 months after surgery, best-corrected visual acuity (BCVA), slit-lamp appearance (including inflammation, IOL centration, capsulorhexis diameter, posterior capsule opacification (PCO), tonometry, and fundus findings were evaluated. Results The groups did not differ with respect to age, surgical indications and modifications, intraoperative IOL handling, and centration. At day 2, inflammation and capsulorhexis diameters were similar, but IOL decentration was slightly more frequent with Akreos-Fit s IOLs. Six months after surgery, the rates of PCO, posterior synechiae, and BCVA were similar. Akreos-Fit s had slightly smaller capsulorhexis diameters and slightly more capsular contraction and IOL decentration (P40.05). Conclusions Both of the Akreos IOL are feasible for combined phacoemulsification and PPV. Although similar in intraoperative handling, BCVA, and PCO, IOL centration was slightly better with Akreos-Adapt s than with Akreos-Fit s after combined surgery.

Effect of Haptic Material and Number of Intraocular Lens on Anterior Capsule Contraction after Cataract Surgery

“…The four-haptic IOLs may provide a large IOL surface in contact with posterior capsule and a more accurate IOL fixation in the capsular bag, leading to a constant tension on the zonular fibers and less myopic shift [12,32]. This led to the assumption of this study that the stability of four-haptic IOL lessens anterior capsule contraction, but the haptic number and design were not strongly related to anterior capsule contraction.…”

Effect of number and position of intraocular lens haptics on anterior capsule contraction: a randomized, prospective trial

“…In the present study, we focused on the number and position of the haptics in the circular zonule, because ACO may be caused by LEC growth, whereas ACC is accelerated by the difference between the centripetal force of the anterior capsule opening margin (fibrotic force) and the centrifugal force of the capsular zonule [ 18 , 19 ]. Some studies have suggested that four-haptic IOLs confer a large surface that contacts the posterior capsule, as well as more accurate IOL fixation within the capsular bag, leading to constant tension on the zonular fibers [ 28 ]. However, later studies reported that the number and design of haptics were not strongly associated with ACC [ 27 ].…”

Surgical and Functional Results of Hybrid 25-27-Gauge Vitrectomy Combined with Coaxial 2.2 mm Small Incision Cataract Surgery

“…Compared with 25-gauge phacovitrectomy, more frequent IOL decentration has been observed with 20-gauge vitrectomy combined with phacofragmentation [ 46 ]. Better centration has been recorded with a 4-point haptic design IOL compared with an intraocular lens incorporating a 2-point haptic design [ 47 ]. In a comparative study, Leiderman et al [ 48 ] revealed that single-piece acrylic IOLs are associated with a low rate of surgical complications after combined phacovitrectomy.…”