IOL gives broader range of focus

Fluid-driven IOL nearly doubles accommodation of previous designs

Roibeard O’hEineachain

Posted: Monday, April 1, 2019

A new version of the FluidVision accommodating intraocular lens (IOL), the FluidVision 20/20 (PowerVision), can provide a broader range of focus than earlier models, according to the results of a study presented by Louis D. “Skip” Nichamin, MD at the 36th Congress of the ESCRS in Vienna, Austria.

“The next-generation FluidVision accommodating IOL demonstrates excellent and stable monocular visual acuity at distance, intermediate and near,” said Dr Nichamin, Vail, Colorado, USA.

In a pilot multi-centre clinical study involving 27 patients who underwent monocular implantation of the new FluidVision IOL, the mean best monocular corrected distance visual acuity in eyes with the lens was stable at logMAR -0.05 at six months’ follow-up. In addition, the average distance-corrected intermediate and near visual acuities were logMAR 0.05 and logMAR 0.14 for the same period.

The mean objective accommodation at six months, measured by autorefractor, was nearly twice that achieved by the earlier FluidVision lens. The average accommodative amplitude was 2.0D, although some eyes achieved objective accommodation up to 4.1D.

In addition, the average mesopic contrast sensitivity was equivalent to an age-adjusted reference population and patients were not troubled with the dysphotopsias common to IOLs with light-splitting technologies, he reported.

The trial was conducted at six sites in South Africa and enrolled 28 patients with a mean age of 66 years (range 51-82 years). All underwent implantation with the FluidVision 20/20 AIOL through a 3.5mm incision using the PowerJect injector system.

The FluidVision IOL is a hydrophobic acrylic lens with a hollow optic and two hollow haptics that are filled with a refractive index-matched silicone fluid and are connected by fluid-filled channels.

When the ciliary muscle contracts in response to a near stimulus, the resulting relaxation of zonular fibres causes the capsular bag to contract, forcing fluid from the haptics into the optic, making it more convex and thereby increasing its dioptric power.

“FluidVision movement translates into a true shape change for seamless vision from near to distance,” said Dr Nichamin.

In addition to the enhanced near-focusing power, the improved design of the latest version of the IOL makes it easier to implant and to teach how to implant than the earlier model. Two international multi-centre controlled studies are currently under way in several countries and are progressing very well, he said.

“The results of our study were consistent with expectations and predict the ability to meet design objectives and deliver 20/20 vision at all distances,” Dr Nichamin concluded.

Louis D. “Skip” Nichamin: