Multicomponent IOL offers benefits

IOL with exchangeable optic allows for easier enhancement procedures

Roibeard O’hEineachain

Posted: Friday, December 7, 2018

Harvey Siy Uy MD

The multi-component Precisight intraocular lens (InfiniteVision Optics) can allow the precise predictable adjustment of postoperative refraction through exchange of the anterior optical element, without exchanging the entire IOL, said Harvey Siy Uy MD, Peregrine Eye and Laser Institute, Makati, Philippines.
“This lens provides a safe, consistent and efficient method of improving refractive and visual outcomes after cataract surgery. The enhancement procedure is fast, easy to learn and enables surgeons to optimise refractive outcomes,” Dr Uy told the 36th Congress of the ESCRS in Vienna, Austria.
Dr Uy and associates assessed the predictability of enhancement procedures in a series of 30 patients who had manifest refraction spherical equivalent (MRSE) greater than 0.75D following cataract removal and implantation of a pre-assembled, multi-component IOL into the capsular bag.
The surgeons performed the enhancement procedures from three months to one year after the primary surgery. It involves separating the front lens from the base lens and removing it through the original incision using IOL forceps. Then a new front lens with a different refractive power was injected into the anterior chamber and attached to the base lens, Dr Uy explained.
Following the enhancement procedure, the mean uncorrected visual acuity improved from a pre-enhancement value of 0.2 logMAR to 0.0 logMAR (p=0.008). In addition, the mean MRSE improved from a pre-enhancement value of +1.39D to +0.09D after enhancement (p=0.0002). Furthermore, after enhancement, all eyes had UDVA of 0.1 logMAR or better.
Dr Uy noted that all of the procedures were completed within five minutes or less. None of the eyes developed significant adverse events. Furthermore, there was no change in the anterior chamber depth after the procedure, nor was there was a significant decrease in endothelial cell density.
Patients who could benefit from multicomponent IOLs include patients with refractive errors, those who are intolerant of multifocal IOLs and those who decide that they would like to try multifocality, Dr Uy said.
A difficulty with treating presbyopia with multifocal IOLs in the past has been the difficulty of predicting patient satisfaction and tolerance of multifocals. An early IOL exchange in cases of dissatisfaction is easier but will not give patients time to neuroadapt. IOL exchange at a later stage is more complicated because of fusion of the capsule. However, because its base lens and haptics remain in place during enhancement procedures, the Precisight has no such time limitations.

Harvey Siy Uy: