Abstract
Abstract: :
Purpose: To determine what is necessary for an IOL to be able to perform and meet the requirements necessary for a pseudophakic IOL to function as a truly "refractive" device. Methods: To determine what the apparent requirements are for a toric or pseudo–accommodative pseudophakic IOL to perform as a "refractive" device, i.e., to be biocompatible; provide a sharp undistorted retinal image; remain anatomically stable without rotation, anterior – posterior (A–P) displacement, tilt, or decentration; an analysis of peer–reviewed literature up to December 2003 was done. Results: Compared to silicone and hydrophilic IOLs, hydrophobic acrylates possess superior biocompatibility as measured by PCO, ACO, and stability in the capsular bag. Studies of the inflammatory response to IOL materials vary as to which material has the lease associated inflammatory response. A one–piece hydrophobic acrylate (Acrysof SATM) has little rotation (<10°), tilt (<7°), decentration (<0.4mm) and has A – P stability over time and therefore superior stability within the capsular bag. Conclusions: Hydrophobic acrylates (HA) have superior biocompatibility as demonstrated by clear anterior and posterior capsules and absence of fibrosis post operatively. A one piece HA (AcrySof SATM) is stable in the capsular bag relative to centration, rotation, tilt and A – P displacement compared to other IOL materials and designs. These are necessary characteristics for an IOL to function as an effective intraocular refractive device.
Keywords: cataract • refractive surgery: phakic IOL