Hydraulic insertion

High satisfaction three years on with fluid-filled accommodating lens

Roibeard O’hEineachain

Posted: Friday, September 1, 2017

The FluidVision (PowerVision, Inc) accommodating intraocular lens (IOL) demonstrates excellent and stable monocular and binocular visual acuity at distance, intermediate for periods now reaching three years, according to Paul Roux MD, Pretoria, South Africa.

A study including 34 eyes from 26 patients who underwent implantation of the FluidVision lens was performed by two surgeons. Eight patients underwent implantation in their fellow eye 15 to 21 months after the first surgery, Dr Roux said.

In 36 months of follow-up, the patients’ mean distance visual acuity remained stable at 6/6. Furthermore, distance-corrected intermediate and near vision were 6/7.5 and 6/9, respectively.

The mean amplitude of accommodation as measured by defocus curves in those implanted monocularly was about 3.0D throughout follow-up, he added. In those with the implant in both eyes it was around 4.0D.

Binocularly implanted patients reported little or no difficulty in performing intermediate/near activities without spectacles, and those with 12 months’ follow-up said they were satisfied.

He noted that the IOL has 6.0mm optic and an overall diameter of 10mm. The haptics of the hydrophobic lens are filled with a small volume of silicone fluid with the same refractive index as that of the optic. Its accommodative effect is achieved through the pressure exerted on the fluid-filled haptics in response to constriction of the ciliary muscles and relaxation of the zonular fibres in response to a near stimulus. That in turn pushes fluid from the haptic into the optic, causing an increase in its anteroposterior diameter resulting in an improved near focus.

The team implanted the lens using a hydraulic injector device in order to deliver the large lens into the capsular bag. They used a 4.0mm clear corneal incision, which they closed with a suture. The latest FluidVision lens can be implanted through a 3.5mm incision that does not require sutures. It is also designed to achieve twice the accommodative power as the lens used in the study.

Paul Roux, C/O Frik Potgieter MD, FRCS, Pretoria, 
South Africa:

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