Long-Term Uveal and Capsular Biocompatibility of New Accommodating IOL

Kohl, Justin

Long-Term Uveal and Capsular Biocompatibility of New Accommodating IOL

Monday, April 28, 2014: 1:57 PM

Room 151A (Boston Convention and Exhibition Center)

Justin Kohl, MD, University of Utah, Salt Lake City, UT, USA

Joshua R. Ford, MD, Moran Eye Center, University of Utah, Salt Lake City, UT, USA

Scott C. Cole, MD, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA

Shail A. Vasavada, MD, John A. Moran Eye Center, Salt Lake City, UT, USA

Liliana Werner, MD, PhD, John A. Moran Eye Center, Salt Lake City, UT, USA

Nick Mamalis, MD, Moran Eye Ctr/Univ of Utah, Salt Lake City, Utah, USA

Gareth Gardiner, BS, John A. Moran Eye Center, Salt Lake City, UT, USA

Narrative Responses:

Purpose
To evaluate for the first time long-term uveal and capsular biocompatibility of a new accommodating intraocular lens (IOL), consisting of a hollow, fluid-filled hydrophobic acrylic optic and, hollow, fluid-filled haptics (FluidVision, PowerVision Inc., Belmont, CA). The fluid (index-matched silicone oil) flows through channels between the haptics and optic allowing for change in lens power.

Methods
Bilateral phacoemulsification was performed on 14 New Zealand white rabbits; one eye received the test IOL and the other a commercially available hydrophobic acrylic control lens. Six rabbits were sacrificed at 2 months and the others were sacrificed at 6 months. Slit lamp examinations were performed at postoperative weeks 1-4; months 2, 3, and 6. Uveal and capsular biocompatibility was assessed at each exam. The remaining rabbits were sacrificed at the end of the study (6 months). Selected IOLs were removed and underwent implant cytology. All globes were sectioned and processed for histopathologic examination.

Results
Up to the six-month follow up, uveal biocompatibility was similar between test and control lenses. At the gross examination at 6 months, central PCO was scored as 0.8 +/- 0.5 with test lenses, and as 3.7 +/- 0.4 with control lenses (P < 0.0001 two-tail; Paired T-Test). Peripheral PCO was 1.6+/- 0.6 with test lenses, and 4 +/- 0 with control lenses (P < 0.0001 two-tail; Paired T-Test). Soemmering’s ring intensity x area was 4+/- 1.4 with test lenses, and 11.3+/-3.2 with control lenses (P = 0.001 two-tail; Paired T-Test). Histopathologic examination confirmed the relative lack of capsular opacification in test eyes, in comparison to controls. Implant cytology of test and control lenses showed a mixture of macrophages, epithelioid cells, giant cells, and spindle-shaped cells attached to their optic surface.

Conclusion
The FluidVision accommodating IOL maintains an open, expanded capsular bag secondary to the size of the haptic elements which appears to prevent capsular bag opacification, while retaining appropriate uveal biocompatibility. The IOL remained stable in the capsular bag and no other capsular reaction was noted.