Results of Hydrophobic Acrylic IOL Insertion

through Corneal Microincisions Smaller than

2.0 mmTomoichiro Ogawa, Takuya Shiba

Hiroshi Tsuneoka

Jikei University School of Medicine, Tokyo, Japan

Authors have no financial interests

AF-1 iMics1 （ HOYA ）• Hydrophobic acrylic intraocular lens (IOL)• Implanted through corneal microincisions

Y-60HY-60HiMics1iMics16mm

AF-1 iMics1 （ HOYA ）• Injector : ISH004(HOYA)• Cartridge : Type-N18 （ HOYA ）

oPreferred incision size:Cornea, 2.0 mm; Sclera cornea, 1.8 mm

PurposeTo evaluate the safety and efficacy of

cataract surgery with implantation of the AF-1 iMics1 IOL through a corneal microincision

Subjects and Method• May - August 2009• Jikei University Hospital• Procedures: 69 eyes

• 1.7-mm （ inner scale ） corneal incision: 47 eyes• 2.0-mm （ inner scale ） corneal incision: 22 eyes

• Operative method• 1.4-mm temporal corneal incision • Bimanual phacoemulsification• Incisions enlarged to 1.7 or 2.0 mm • Implant AF-1 iMics1

Variables examined• Incision size （ before and after IOL

implantation ）• Tsuneoka microincision gauge （ ASICO ）

• Increased width of corneal incision after IOL implantation

• Surgery-induced corneal astigmatism （ Cravy method ）• 1 month postoperatively

• Operative complications• Postoperative complications

0.310.22 0.25

0.1

0.2

0.3

0.4

1.9mm 2.2mm Y-60H (2.2mm)

(mm) ＊

**1.7 mm 2.0 mm

Results

**2008. Ogawa. ESCRS.

2.272.052.09

1.791.5

1.7

1.9

2.1

2.3

pre post pre post

1.7mm 2.0mm

(mm)

Wound width

Increased wound width

P=0.0025Mann-Whitney U-test

＊

Results

0.031

-0.057

0.039

0.580

0.200

-0.1

0.1

0.3

0.5

1.9mm 2.2mm Y-60H(2.2mm)

SA60AT(C)(2.2mm)

SN60WF(C)(2.2mm)

（D）

** ** **

＊ NSSurgery- induced corneal

astigmatism

*Mann-Whitney U-test

**2008. Ogawa. ESCRS.

1.7mm 2.0mm

Results　 1.7 mm 2.0 mm

Posterior capsulerupture 0 eye/47 1 eye/22Wound

self-healing 100% 100%

　 1.7 mm 2.0 mmIOL decentration 0% 0%

Cysticmacula edema 0% 0%

Woundself-healing 100% 100%

Operative complications

Post- operative

complications

DiscussionsPosterior capsule rupture

Tip of cartridge is too deep in anterior chamber and too close to posterior capsule

Insertion of cartridge

Tip of cartridge

Tacking tips of both forward and back hapticsО Full length of IOL is greater than that of other foldable

1-piece IOLsAF-1 iMics1 is stiffer

AF-1 iMics1 SN60WF

Full length is greater

IOL is released near posterior capsule

Posterior capsule ruptureIOL implantation

IOL goes through posterior capsule

Posterior capsule ruptures

ConclusionAF-1 iMics1 （ HOYA ）

• Implanted through corneal incision < 2.0 mm• Little surgery-induced astigmatism • Wound self-healing• Carefully position tip of cartridge