EyeWorld Asia-Pacific December 2016 Issue

34 December 2016 EWAP CATARACT/IOL Supported by an education grant from Abbott Medical Optics The news magazine of the Asia-Pacific Association of Cataract & Refractive Surgeons APACRS Asia-Pacific New hydrophobic lens and innovative technology highlighted in symposium A symposium sponsored by HOYA Surgical Optics (Singapore) at the Asia- Pacific Association of Cataract & Refractive Surgeons (APACRS) meeting in July in Nusa Dua, Bali focused on “Innovative Technology and Long-Term Clini- cal Outcomes in Cataract Surgery.” The session was moderated by Soon Phaik Chee, MD , Singapore. During the session, Gerd Auffarth, MD , Heidelberg, Germa- ny, spoke about improvements in acrylic material. Material is import- ant because patients are getting younger, he said, so if the material deteriorates over time, that’s not ideal. Properties of a good intraocu- lar lens include excellent biomate- rial (optical purity), foldability and pre-loaded delivery, optical quality and refractive reliability, excellent capsular bag performance, and sharp edge technology for PCO preven- tion, he said. Hydrophobic acrylic IOL mate- rial has already been in the research field for more than 30 years, Dr. Auffarth said, and there have been many problems with the material, particularly because of glistening formation. These lenses were initial- ly very stiff but have changed over time, he said. Glistenings are specific to hydrophobic material. Dr. Auffarth spoke about the Vivinex TM lens (HOYA), which is made of hydrophobic material. It can be inserted through a small incision and can be injected nicely into the capsular bag with control, he said. The material is not as hard as other hydrophobic materials, so it slides well into the injector, he added. In order to address the poten- tial for glistening complications, Dr. Auffarth said the lens was tested with a specific treatment process and graded for glistenings. This testing method includes putting the lenses in an oven for a 24-hour period to accelerate the glistening process. Then, the lenses go into a con- trolled cooling process for several hours. The lenses are treated this way and put under a microscope. Photographs are taken, and software analyzes the number of glistenings and the size of the glistenings. The HOYA Vivinex™ lens, Dr. Auffarth said, showed “essentially zero glis- tenings.” With this process, there is a reproducible setup for experimental glistening formation, he said. It’s ideal for comparative studies and identifies significant differences among various materials and manu- facturers, Dr. Auffarth added. There are great variations among hydro- phobic IOLs from different manu- facturers, but the Vivinex TM IOL has shown to be glistening free, he said. Hiroko Bissen-Miyajima, MD , PhD , Tokyo, presented on clinical data with a new IOL material to reduce PCO with a hydrophobic acrylic lens. Dr. Bissen-Miyajima first discussed HOYA and its recognition in Japan before specifically discuss- ing the Vivinex TM lens, sharing clin- ical outcomes and 3-year follow-up data from studies of this lens. Everyone wants cataract surgery with less PCO, she said. A square edge is known to reduce PCO, but it’s not perfect. With the Vivinex TM the posterior surface of the IOL is modified to increase adhesion to the posterior capsule. Dr. Bissen- Miyajima shared a video from Prof. Supplement to EyeWorld Asia-Pacific Winter 2017 Hiroyuki Matsushima (Japan) detail- ing the way the surface of the IOL is modified to improve adsorption of adhesive proteins through a simple and effective UV ozone treatment. Dr. Bissen-Miyajima described outcomes from a 3-year follow-up of a clinical trial from 2009 to 2011 in Japan. The trial was a multicenter, single-blinded, parallel-group study looking at 180 eyes of 90 patients. The study featured a group with the Vivinex TM IOL, a hydrophobic acrylic IOL with a sharp frosted edge with an incision size of 2.0 mm, and a control group with a hydrophobic acrylic IOL with an incision size of 2.5 mm. Results indicated that eyes with the Vivinex TM showed a lower rate of PCO and lower density of the poste- rior capsule compared to the control group. Additionally, results showed that glistenings were reduced in the Vivinex TM eyes compared to the control group. The lens has been approved in Japan since 2012. It offers an easy implantation through a less than 2 mm incision, Dr. Bissen-Miyajima said. The Vivinex TM IOL and iSert ® Source: HOYA Evaluation of glistening grading by in-vitro test – average Miyata grading Source: Gerd Auffarth, MD (David Apple Institute, Heidelberg, Germany)