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      Long-term clinical results and scanning electron microscopic analysis of the aspheric, hydrophobic, acrylic intraocular lens CT LUCIA 611P(Y)

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          Abstract

          Purpose

          The aim of this study was to evaluate the clinical outcomes of a novel designed hydrophobic, acrylic, monofocal, fully preloaded intraocular lens (IOL; CT LUCIA 611P) 1 year after implantation. Scanning electron microscopic analysis regarding the optic–haptic junction and sharp edges of the IOL was performed.

          Patients and methods

          This is a noninterventional, observational prospective study of cataract patients who underwent implantation of the CT LUCIA 611P. Ninety-six eyes of 54 subjects were enrolled. Follow-up included visual acuity assessment, slit lamp examination with special focus on appearance of glistenings and evaluation of posterior capsule opacification (PCO). Scanning electron microscopic analysis of the new designed optic–haptic junction and edges of the IOL was performed.

          Results

          Best-corrected distance visual acuity increased from mean 0.48 logMAR (range 0.86–0.34) preoperatively to mean 0.02 logMAR (range 0.14 to −0.10) 1 year after surgery. Thirty-eight of 42 subjects’ eyes (90.5%), which underwent bilateral surgery with implantation of the IOL, never required glasses for distance again, while 4 (9.5%) required glasses only in rare cases (eg, driving at night). The spherical equivalent was within ±0.50 D in 88 of 96 subjects (91.7%) and within ±0.75 D in 96.9% of cases. Target refraction ±1.00 D was achieved in 100% of subject eyes. No glistenings were reported in any case. From the surgeons’ perspective, the wider, thicker optic–haptic transition of the IOL resulted in significantly increased stiffness, which enabled improved centering of the IOL and enhanced rotational stability and refractive predictability and stability and PCO prevention.

          Conclusion

          The results of this long-term observational study demonstrate the safety and efficacy of the IOL. Because of the completely new designed thicker and stiffer optic–haptic junction regarding improved characteristics of the IOL (stability in the capsular bag), some special attention has to be addressed to the slightly different behavior of the lens during implantation and unfolding process.

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          Most cited references21

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          Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review.

          Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options.
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            Dispersive-cohesive viscoelastic soft shell technique.

            Based on their physical properties, ophthalmic viscoelastic agents can be divided into 2 groups: higher-viscosity cohesive and lower-viscosity dispersive. Higher-viscosity cohesive agents are best at creating and preserving space, while lower-viscosity dispersive agents are retained better in the anterior chamber and are capable of partitioning spaces. The viscoelastic soft shell technique maximizes the advantages and minimizes the disadvantages of both groups by using dispersive and cohesive agents together in sequence based on the desired surgical goal.
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              Modern cataract surgery: unfinished business and unanswered questions.

              We summarize information, based on clinicopathologic studies over the past decade, on various cataract intraocular lens (IOL) procedures and modern "specialized" IOLs, that will help surgeons continuously improve long-term results for cataract patients. Although most operations do initially provide excellent refractive correction and visual rehabilitation, late complications occur. These sometimes are missed because they are outside of the routine period of follow-up care. We have tried to determine if the various techniques and IOLs truly deliver the long-term results that we desire. Most safety and efficacy information is derived from the manufacturer and is passed through the U.S. Food and Drug Administration (FDA). This is often based on limited, relatively short-term observations made by the manufacturer. After a lens receives FDA approval, there are few means to assess the outcome of each procedure and lens years later. We rarely hear of a 10- or 20-year follow-up study. We have found that one of the best means to assess long-term results is pathologic analyses. We discuss recently studied aspects of pathologic reactions, such as posterior capsule opacification, intracapsular fibrosis, glistenings, intralenticular opacification, and other issues with the various IOL platforms; we then present a clinicopathological overview of tissues and IOLs from our database. These include hydrophobic and hydrophilic acrylic designs, plate lenses, and a dual optic lens. Copyright © 2011. Published by Elsevier Inc.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2018
                05 July 2018
                : 12
                : 1219-1227
                Affiliations
                Borkenstein & Borkenstein, Privatklinik der Kreuzschwestern, Graz, Austria, ordination@ 123456borkenstein.at
                Author notes
                Correspondence: Andreas F Borkenstein, Borkenstein & Borkenstein, Private Practice at Privatklinik der Kreuzschwestern, Graz, Austria, Tel +43 316 331 3880, Email ordination@ 123456borkenstein.at
                Article
                opth-12-1219
                10.2147/OPTH.S167895
                6038869
                30013315
                035e2491-fba9-4e54-9e0b-ff4c99d286ac
                © 2018 Borkenstein and Borkenstein. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Ophthalmology & Optometry
                intraocular lens,iol,ct lucia 611p(y),cataract surgery,quality of vision,aspheric design,glistenings,square edge,achilles heel of the iol

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