Abstract
Purpose :
To compare haptic tensile strength between commonly used 3-piece intraocular lens (IOL) with a Light Adjustable Intraocular Lens (LAL), for Yamani Scleral Fixation.
Methods :
An ex-vivo, single-center study was conducted. Maximum haptic tensile strength was compared with different 3-piece IOLs, including MA60AC, CT Lucia, and LAL. Haptic strength with a 24-diopter IOL was compared across all lenses, as well as a wider range of 10-30 diopters with the MA60AC. A custom device was created to hold the IOL with equal surface tension while maintaining the same haptic orientation for each test. One haptic was threaded into the opening of a micro 200g tensiometer with the terminal bulb melted using cautery. Using a fixed crank attached to the tensiometer, the tensiometer was moved away from the optic at a standardized velocity, increasing the tension by 1 gram per second. Tension was held an additional 5 seconds at 25-gram intervals. The max tension was recorded when the optic was unable to maintain tension or broke.
Results :
The max haptic tension (mean +/- standard deviation) was greatest for the 24D CT Lucia (n=10) at 156 +/- 11.3g compared to 24D MA60AC (n=10) at 103 +/- 13.7g and 24D LAL (n=10) at 84 +/- 13.8g, P<0.0001. There was no significant difference in haptic tension for MA60AC with varying diopter lenses. High magnification imaging revealed the highest haptic fractures for MA60AC at 40% compared to LAL and CT Lucia at 0%. LAL had the highest rate of optic fracture at 40% compared to 0% of CT Lucia and MA60AC. CT Lucia had 100% of the haptics pulled out of the IOL without any damage compared to 60% LAL and 60% MA60AC.
Conclusions :
CT Lucia is considered the gold standard for scleral fixation and was able to consistently maintain the highest level of tension before failure among all examined lenses. Although the LAL had the lowest max tension, no fracture of the haptics with high magnification was observed, lending the possibility that scleral fixation may be possible in the hands of an experienced surgeon.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.