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Comparison of intraoperative behavior and post-operative outcomes of aspheric hydrophobic AcrySof IQ, Tecnis aspheric and hydrophylic aspheric Rayner C-flex IOLs

Poster Details

First Author: Z.Mazhry PAKISTAN

Co Author(s):                  

Abstract Details



Purpose:

This study was focused on evaluation and comparison of intra and post-operative behavior of Aspheric Hydrophobic AcrySof IQ, Tecnis Aspheric and Hydrophylic Aspheric Rayner C flex IOLs. The emphasis was on outcomes related to IOL and its Injection system in terms of safety, ease of insertion and post op results especially incidence of PCO.

Setting:

WAPDA Teaching Hospital and Central Park Medical College

Methods:

300 eyes of 280 patients needing phaco cataract surgery with IOL implantation were included in the study. 100 eyes each were allotted to each group randomly. All patients were between 40 to 81 years of age. Patients with nuclear sclerosis less than plus 2 and with no other co morbid ocular pathology were randomly assigned to each group. Prospective study was planned from January 2011 to June 2013. Aspheric Hydrophobic AcrySof IQ, Tecnis Aspheric and Hydrophylic Aspheric Rayner C flex IOLs were implanted using IOL insertion systems recommended by respective manufacturers. Routine pre-op evaluation and biometry using Topcon manual keratometer and Sonomed bio meter were carried out. All the patients were operated by same surgeon using clear corneal incision 2.75 mm placed at steeper meridian. Patients with intra operative Anterior or posterior capsular rip were excluded from the study. Post-operative assessment was performed one day 1, 1 week, 1 month and every 6 months thereon. Minimum follow up was 6 months and ranged from 6 months to 30 months.

Results:

All 100 eyes in each group had smooth assembly of insertion system and intra-bag insertion of IOL. During the implantation controlled smooth unfolding was observed in case of AcrySof IQ group. It was less smooth and less controlled in both Tecnis and Rayner groups. Superior haptic catch/damage was noticed in 4 cases in Rayner group, one in Tecnis and none in IQ group. Excessive force and over shooting occurred in Tecnis group frequently, however this was not an issue in Rayner and AcrySof IQ groups. IOL was excellently centered intraoperative and remained so in post op follow up. We did not observe any adverse effects related to the lens and/or the injection system. Post operatively the IOLs were well centered in all the groups. No biometric surprise was noticed in any of the groups. Final visual outcome was in the range of 6/6-6/9 in all the groups with no statistically significant difference. Significant PCO needing YAG capsulotomy was observed in 7 eyes in Rayner group followed by 4 and 2 eyes in Tecnis aspheric and AcrySof IQ group.

Conclusions:

All three types of IOLs and their Insertion systems were found to be safe and effective. However AcrySof IQ IOL and its insertion system carries a definitive edge over Rayner and Tecnis IOLs regarding its surgeon and patient friendly intra and post-operative behavior. Incidence of PCO was significantly less in both hydrophobic groups as compared to hydrophilic Rayner group. However long term studies are needed to further clarify this fact. FINANCIAL INTEREST: One of more of the authors... travel has been funded, fully or partially, by a competing company

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