Ophthalmic viscoelastic devices (OVDs) are currently used in cataract surgery and have significantly improved the safety and effectiveness of this surgical procedure. OVDs are classified according to the zero-shear viscosity and the cohesion-dispersion index in cohesive, dispersive, and viscoadaptives. OVDs create and maintain anterior chamber depth and visibility, protecting the corneal endothelium and other intraocular tissues during surgery. The selection of the most adequate OVD is especially relevant when performing cataract surgery in challenging cases, such as in hard, mature cataracts, flat anterior chamber, pseudoexfoliation syndrome, intraoperative floppy iris syndrome, or glaucoma surgery. In such cases, OVD is crucial for facilitating the surgical procedure and the associated minimal complication rate. The use of a combination of OVDs (soft-shell technique and modifications), the use of blue-colored OVDs, and the combination of sodium hyaluronate with lidocaine have also been described as useful tools in some of these challenging cases.

PurposeThe 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 methodsThis 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.ResultsBest-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.ConclusionThe 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.

Introduction: Characteristics of the haptics and optic-haptic junction (OHJ) of an intraocular lens (IOL) affect IOL position in the capsular bag, positional stability, and the development of posterior capsule opacification. Therefore, the haptics and OHJ have a role in determining initial and long-term visual outcomes after cataract surgery. Understanding differences in the haptics and OHJ of available IOLs and in the relationships between the haptics of each IOL and the capsular bag across a range of capsular bag sizes might inform selection of an IOL model for individuals. Purpose: To evaluate the geometry of five currently marketed, commonly used one-piece hydrophobic acrylic monofocal IOLs and changes in haptic-capsular bag relationships according to capsular bag size using a range of compression well diameters. Methods: AcrySof SN60WF, CT LUCIA 621PY, enVista MX60, TECNIS ZCB00, and Vivinex XY1 IOLs were scanned with computed tomography (CT) in a dry, uncompressed state for quantitative analyses of haptic and OHJ dimensions and qualitative assessment of

The objective of this study was to assess the rate of posterior capsule opacification (PCO), under "real-life" conditions, as measured by rates of Nd:YAG laser intervention, rather than from a controlled study from which patients with conditions predisposing to PCO have been excluded. Methods and Analysis: This was a retrospective, multicenter study in an unselected consecutive cohort of patients undergoing surgery for senile cataract. Patients aged 18 years and older, previously implanted with the CT LUCIA 611P IOL, were contacted at 12, 18 and 24 months to ascertain if they had received Nd:YAG laser treatment. There was an additional assessment at 36 months at the Austrian centre. Results: A total of 200 patients were recruited at two centers. Laser capsulotomy rates were 4.5% at 1 year and 10% by year 2 and 12% by year 3. Three Nd:YAG capsulotomies, carried out at other external centers, were performed for reasons other than PCO, including astigmatism, epiretinal membrane and ARMD. If these patients are excluded, the true rate of Nd: YAG carried out for PCO at 1 year was 3.5% and at 2 years was 8.5%. Conclusion: It is critical to ensure that Nd:YAG capsulotomies are being performed only for the correct clinical reason. Carrying out unnecessary procedures places the patient at risk of adverse events, is a cost to the healthcare system, and is likely to have no direct visual benefit for the patient. In PCO studies, it should be a requirement to document the fibrosis grade to confirm that Nd:YAG capsulotomy was correctly indicated.

PurposeThe purpose of this study was to describe our surgical experience and evaluate safety and postoperative outcomes of a fully preloaded, monofocal, hydrophobic acrylic intraocular lens (IOL) (CT LUCIA 611P) with a newly designed optic-haptic junction in severe cases of pseudoexfoliation (PXF) syndrome, phacodonesis, and small pupils.SettingThis study was conducted in Borkenstein & Borkenstein, private practice, Privatklinik der Kreuzschwestern Graz, Austria.Patients and methodsThis study presents outcomes of 15 eyes of 15 patients implanted with CT LUCIA 611P IOL with improved optical properties and more rigid and wider optic– haptic junction. All patients had advanced cataract and PXF syndrome, of which phacodonesis was detected in 12 cases and five cases had PXF glaucoma. All eyes had small pupils with no response to mydriatic drops, and the surgery was performed with the use of Malyugin ring. All eyes were targeted for a slight postoperative myopia (−0.25 to −0.50 D). Refractive outcomes were presented for 3 months follow-up, while adverse events were followed up for to 10 months.ResultsThe mean age of the study group was 78.3 years (from 68 to 86 years). Three months postoperatively, the mean manifest spherical equivalent was −0.35 D (from 0.00 to −1.00 D) and all eyes were within ±0.50 D of their preoperative target. No significant refractive shift or refractive surprise occurred during the follow-up of 10 months. Corrected distance visual acuity (CDVA) improved from the mean value of 20/50 preoperatively to 20/20 postoperatively. No intraoperative adverse events were noted. Postoperatively, six eyes presented with a slight decentration or tilt, which did not significantly affect postoperative refraction, CDVA, or patients’ subjective visual symptoms.ConclusionThe IOL provided good surgical performance, excellent refractive stability, and predictable outcomes in patients with PXF syndrome. Further studies are necessary to evaluate long-term stability.