Long-Term Quantitative Analysis of Posterior Capsule Opacification After Implantation of Dual-Optic Accommodating IOLs

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Long-Term Quantitative Analysis of Posterior
Capsule Opacification After Implantation of
Dual-Optic Accommodating IOLs

• Andrea Galvis, MD 1 , 3
• Ivan Ossma Gomez,MD MPH 1 , 2
• 1 Fundación Valle del Lili Cali, Colombia
• 2 Universidad Industrial de Santander
  Bucaramanga, Colombia
• 3 Fundación Oftalmológica de Santander
  Bucaramanga, Colombia

Authors are clinical investigators for the
Synchrony Dual Optic Accommodating IOL
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Synchrony Dual Optic Accommodating IOL

• Fills the capsular bag
• Designed to provide accommodation via forward
  movement of the anterior optic
• Potential for movement could be impaired by
  capsule opacification
• ACO
• PCO

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Clinical Experience Synchrony

• Good unaided distance, intermediate and near
  visual function 1,2,3
• Subjective and objective evidence of
  accommodative amplitude 4,5,6
• Stability of over 2 years 1,2
• Low PCO rates 7
• Functional range of vision exceeding that of
  multifocals 8

1 Alarcon et al. ESCRS London 2006 2 Ossma et al.
ASCRS San Francisco 2006 3 Beiko G. ESCRS London
2006 4 Ossma et al. ASCRS San Diego 2004 5 Galvis
et al. ASCRS Washington 2005 6 Bohorquez et al.
ESCRS London 2006 7 Galvis et al. ESCRS Berlin
2008 8 Ossma et al. ASCRS Chicago 2008
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Rabbit Studies
Synchrony
Plate Haptic IOL

• Difference in PCO
• Synchrony 0.714 0.751
• Plate haptic IOL 3.142 0.899

• Werner et al. JCRS 2004 1114-23

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Study Design

• Prospective Observational Analytical Study
• 3 Groups
• Synchrony IOL Implantation (43 eyes)
• Alcon SN60D3 (42 eyes)
• Alcon SN60AT Implantation (54 eyes)

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Study Design

• Digital retroillumination photographs (3,6,12 and
  24 months)
• Evaluate incidence PCO
• OSCA System
• Evaluate incidence ACO
• Photography grading one observer

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OSCA (Open Access Systematic Capsule Assessment)

• Aslam et al. ¹-²-³
• Based on texture analysis
• Objective
• Valid
• Reliable

¹ Aslam et al. BMC Ophthalmology 2005, 59 ²
Aslam et al. BMC Ophthalmology 2006, 630 ³ Paton
et al. BJO 2002, 861181-87
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Study Population
Synchrony (n43) SN60D3 (n42) SN60AT (n54)
Age 68.8 5.4 68.5 5.4 70.1 5.6 p0.55
Residual Refraction Defocus Equivalent 0.32 0.153 0.22 0.184 0.20 0.157 p0.48
Kruskal Wallis Analysis of Variance
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Results
Alcon SN6AD3 21.3 months postop
Synchrony 20.7 months postop
Alcon SN60AT 21.1 months postop
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OSCA Score Evolution
p0.41
p0.83
OSCA Score
p0.27
p0.38
Mann-Whitney Test
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Anterior Capsule OpacificationMonth 12
Synchrony n43 SN60D3 n42 SN60AT n54
None - Mild 40 (93.1) 35 (83.3) 47 (87)
Moderate 3 (6.9) 7 (16.7) 6 (11.1)
Severe 0 0 1 (1.9)
Fishers Exact Test p0.37
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Conclusion

• Elements in design of Synchrony Dual Optic
  Accommodating Intraocular Lens
• Minimize ACO
• Minimize PCO
• Synchrony Dual Optic Accommodating IOL
• PCO Rates comparable to those of acrylic
  monofocal and multifocal IOLs

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Thank you
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