“Laboratory Study Evaluating the

New Preloaded Hydrophobic Acrylic

IOL – Medicontur – Bi-Flex”

Liliana Werner, MD, PhD

Financial disclosures:

-Research supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New

York, NY, USA to the Department of Ophthalmology and Visual Sciences, University of Utah.

-Contract Research Studies performed with different companies, including: AMO, Alcon, Anew

Optics, Bausch & Lomb, ClarVista Medical, CORD, Hoya, LensGen, Medicontur, Mynosys, Omega,

Powervision, Rayner, Zeiss.

1) Assessment of Surface and Edges

• Five (5) IOLs not preloaded (+21.0 D)

• Scanning electron microscopy: Surface Science and

Nano-Imaging Lab, University of Utah

• FEI Quanta 600F ESEM (low-vacuum mode)

• Pressure of 0.5-1 torr at room temperature (23º C);

accelerating voltage of 10-15 kV

• No need of prior coating of specimens

Overall smooth surface

Edge at optic-haptic junction

Ness PJ, Werner L, Maddula S, et al. Pathology of 219 human cadaver eyes with 1-piece or 3-piece hydrophobic acrylic

IOLs: capsular bag opacification and sites of square-edged barrier breach. J Cataract Refract Surg 2011; 37:923-930.

Anterior capsule

Posterior capsule

IOL

Pseudophakic Human Eyes Obtained Postmortem

University of Utah

“Microedge study, Part II: Evaluation of

commercially available hydrophobic IOLs”

• Evaluation of optic microedge structure of IOLs

• Currently available IOLs

• Marketed as square edge lenses

• Sixteen designs of hydrophobic acrylic or silicone

• +20.0 D IOL and a +0.0 D IOL (or the lowest

available plus dioptric power)

Werner L, Müller M, Tetz M. Evaluating and defining the sharpness of

intraocular lenses. Microedge structure of commercially available square-edged

hydrophobic lenses. J Cataract Refract Surg 2008; 34:310-317.

(Equiconvex)

X1,000

Area = 281.4 μ240-μ radius

X25

Anterior surfacePosterior surface

In vivo LEC: 8-21 μ in

diameter (larger lengths)

IOL model IOL manufacturer Dioptric power Optic materialArea

(40 Radius)

Area(60 Radius)

Matrix Acrylic Medennium 0.0 Acrylic 69.5 131.8

SA60AT Alcon 20.0 Acrylic 97.2 157.5

SN60WF Alcon (aspheric) 6.0 Acrylic 100.1 159.4

Hydromax Zeiss 10.0 Acrylic 104.4 171.0

SA60AT Alcon 6.0 Acrylic 114.5 122.4

Hydromax Zeiss 19.0 Acrylic 116.5 211.2

Matrix Acrylic Medennium 20.0 Acrylic 133.8 275.5

SN60WF Alcon (aspheric) 20.0 Acrylic 136.5 228.8

L450 Wavelight 20.0 Acrylic 138.8 287.3

VA60BB Hoya 0.0 Acrylic 169.5 111.5

ZA9003 AMO (aspheric) 20.0 Acrylic 188.4 377.8

AR40e AMO 20.0 Acrylic 196.6 403.5

X-60 AVS 0.0 Acrylic 202.7 232.7

ZA9003 AMO (aspheric) 10.0 Acrylic 232.0 391.7

X-60 AVS 20.0 Acrylic 268.0 395.0

MA60MA Alcon 0.0 Acrylic 268.8 524.4

MA60AC Alcon 20.0 Acrylic 278.9 421.0

VA60BB Hoya 20.0 Acrylic 329.7 427.3

AR40M AMO 0.0 Acrylic 338.4 448.3

VA60BB, +20.0 D VA60BB, +0.0 D

Z9003, +20.0 D Z9003, +10.0 D

Matrix Acrylic, +20.0 D Matrix Acrylic, +0.0 D

Hydrophobic Acrylic IOLs

Area deviating from a perfect square: 139 +/- 37 square microns

Area deviating from a perfect square (SN60WF +20.0 D): 136.5

square microns

2a) Assessment of Surface after Injection

• Six (6) preloaded IOLs (+22.5 D)

• OVD provided by the Medicontur (Visco-MC)

• Injection inside vial with distilled water; rinsing

• N = 3: Scanning electron microscopy: Surface Science and Nano-Imaging Lab,

University of Utah

• FEI Quanta 600F ESEM (low-vacuum mode)

• Pressure 0.5-1 torr at room temperature (23º C); accelerating voltage 10-15 kV

• No need of prior coating of specimens

Time injection/SEM: 9 +/- 1 minute

2b) Assessment of Surface after Injection

• Six (6) preloaded IOLs (+22.5 D)

• OVD provided by the Medicontur (Visco-MC)

• Injection inside vial with distilled water; rinsing

• N = 2: Light microscopy

Time injection/light microscopy: 1 +/- 0 minute

Summary

• Anterior and posterior surfaces of the lenses,

including optic and loop components: overall

smooth and regular

• 360-degree square edge present in all lenses

• No marks, folds, damage, or any other alteration of

the lens surface under SEM and light microscopy

after injection

• Mild amounts of residual OVD and few

contaminants (dust-like deposits)

Liliana Werner, MD, PhD

Professor of Ophthalmology

and Visual Sciences

John A. Moran Eye Center

University of Utah

Salt Lake City, UT, USA

Liliana.werner@hsc.utah.edu

Werner.liliana@gmail.com