Evaluation of a Novel Zonular Tension Restoring Accommodating Silicone IOL Design: Pilocarpine and Cyclopentolate-Induced Effect 20 Months after Implantation

Nino Hirnschall; Raoul Paolo D Henson; Jay Marianito S Vicencio; Andrew L Angeles; Oliver Findl; Andrew Phillips

doi:10.1155/2021/4797851

Evaluation of a Novel Zonular Tension Restoring Accommodating Silicone IOL Design: Pilocarpine and Cyclopentolate-Induced Effect 20 Months after Implantation

J Ophthalmol. 2021 Nov 29:2021:4797851. doi: 10.1155/2021/4797851. eCollection 2021.

Authors

Nino Hirnschall^{1

2}, Raoul Paolo D Henson^{3

4

5}, Jay Marianito S Vicencio⁴, Andrew L Angeles^{3

5}, Oliver Findl¹, Andrew Phillips⁶

Affiliations

¹ VIROS-Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria.
² Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Johannes Kepler University Linz, Linz, Austria.
³ Clinica Henson Eye, Ear, Nose, and Throat Foundation, Angeles, Philippines.
⁴ St Lukes Medical Center, Quezon, Philippines.
⁵ Angeles University Foundation Medical Center, Angeles, Philippines.
⁶ Phillips Eye Center, Los Angeles, CA, USA.

Abstract

Purpose: To investigate a novel zonular-stress restoring accommodating 1-piece silicone IOL. Setting. Angeles City, Philippines.

Design: Prospective randomized bilateral study.

Methods: Each patient received a study IOL (ActaLens™, Emmetrope, La Canada, CA) in one eye and a control IOL (CrystaLens® AO, B&L, USA, or an AcrySof IQ®, Alcon, USA) in the contralateral eye to allow for intraindividual comparison. At the 20-month follow-up, two measurement days were set to measure all eyes before and after instilling 2% pilocarpine on the first day and 1% cyclopentolate on the second measurement day using an optical biometry device (Lenstar, Haag-Streit AG, Switzerland), respectively. PCO was graded by two examiners independently at the slit lamp.

Results: In total, 16 eyes of 8 patients were included. In the study group and the control group, the pilocarpine-induced ACD shift was 0.32 mm (SD: 0.12) (p=0.014) and 0.04 mm (SD: 0.16) (p=0.854), respectively. In the study group and the control group, the mean cyclopentolate-induced ACD shift was 0.14 (SD: 0.06) (p=0.014) and 0.03 mm (SD: 0.03) (p=0.181), respectively. PCO and Nd : YAG rates were higher in the study group, but differences were not found to be significant (AcrySof vs. ActaLens p=0.100 and CrystaLens vs. ActaLens p=0.174).

Conclusion: The investigated IOL is a novel concept for an accommodating IOL, and results showed a moderate pilocarpine-induced forward shift of the IOL 20 months following implantation. For all patients, the investigated IOL seems to have a higher PCO rate compared to standard monofocal IOLs.