Iols Design And Material Influence In Nd: Yag Laser Rates For A Large Series Of Mics Iol Implantations.

To study the cumulative neodymium: YAG (Nd:Yag) laser rate (capsulotomy for posterior capsular opacification) after 10850 implantations during cataract surgery of 12 different hydrophilic acrylic MICS lenses and 2 hydrophobic and evaluate the influence of material and design.

Centre Ophtalmologique IRIDIS, Albi, France.

This retrospective study comprises all patients who were implanted between 2004 and the end of 2022 with one of the after 14 MICS IOLs: Akreos MICS and INCISE (Bausch and Lomb), CT Asphina 509 M/MP and AT TORBI 709 M/MP (Carl Zeiss Meditec), Synthesis and Synthesis Toric (Cutting Edge), MicroSlim, Micro AY, MicroPure Ankoris, FineVision Toric and PodEye (BVI-PhysIOL), Lucidis 108 & 124 M/MT (SAV-IOL). The cumulative Nd: Yag laser frequency rates in all groups were calculated, and the cumulative incidence rates were defined by propensity score, Weighted Cox regression, Kaplan-Meier survival analysis and Mann-Withney test.

The 1,5 years survival rate (95% Confidence Interval %) was 100% for the INCISE, PODEye, Lucidis 108M/MT (100-100); 86,7% for the Akreos MICS (83-90); 96,3% for the CT Asphina (95-98); 99,2% for the AT TORBI (99-100); 93,7% for the MicroSlim (92-96); 93,8% for the Micro AY (93-95); 96% for the MicroPure (95-98); 98,2% for the FineVision Toric (96-100); 94,1% for the Ankoris (91-97), 97% for the Synthesis (93-100), 97,4% for the Synthesis Toric (92-100), and 90,7% for the Lucidis 124M/MT (86-96). The 11 years survival percentage was 17,5% for the Akreos MICS (14-23); 33,7% for the CT Asphina (29-39); 52,6% for the Micro AY (50-56) and 61,4% for the MicroSlim (56-68). 

The analysis of this large series of IOL shows a better survival rate for the 22% hydrophilic Incise, and the worst for the 26% acrylic hydrophilic Akreos MICS. Comparisons at 5 years of the same design IOLs but different materials, sometimes show better results for the hydrophobic (PODEye vs Ankoris & FineVision Toric) or the hydrophilic (Micro AY and MicroSlim vs MicroPure) material. The influence of the hydrophobic material to delay the PCO seems to be less effective than the design and industrial process of fabrication.