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Comparison of postoperative results after implantation of preloaded and manually loaded versions of the same hydrophobic acrylic intraocular lens (IOL)

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Session Details

Session Title: New IOLs: Material & Preload IOL

Session Date/Time: Monday 24/09/2018 | 08:00-10:30

Paper Time: 10:15

Venue: Room A3, Podium 2

First Author: : A.Dunai HUNGARY

Co Author(s): :    T. Filkorn   H. Kiss   Z. Nagy              

Abstract Details


To evaluate and compare the predictability of IOL power calculation using two implantation methods of the same hydrophobic acrylic, one-piece intraocular lens design.


Semmelweis University, Department of Ophthalmology, Budapest, Hungary


In this prospective randomised study cataract surgery was performed on 344 eyes using phacoemulsification technique. In Group A (n= 159), Medicontur Bi-flex 877PA IOL, and in Group B (n= 185) Medicontur Bi-flex 877FAB IOL was implanted in the capsular bag. At the end of a 3-month follow-up, the difference of manifested refraction and predicted postoperative spherical equivalent values were compared (mean error, absolute error (ME, MAE)) to evaluate the predictive power of calculation methods (Holladay 1, SRK/T, Hoffer Q, Haigis). The preoperatively predicted (ELPo) and postoperatively measured IOL positions were also compared.


While ME of IOL power calculation was approximately zero in Group A, it showed positive deviation in Group B (Haigis formule, A: +0.02±0.37 D, B: +0.44±0.47 D). Significant difference was found between the two groups, using all four calculation methods (Mann-Whitney, p<0.05). The difference found in MAE was non-significant (Haigis, A: 0.26±0.26 D; B: 0.49±0.41 D). In Group A, predicted and postoperatively measured IOL positions were essentially the same, meanwhile in Group B, IOLs were detected in a slightly deeper (0.17±0.06 mms) position. This could be the explanation of hypermetropic deviation in postoperative period.


Based on our investigations, postoperative refractive results of the 877 Bi-Flex IOL are more predictable using the preloaded version, compared to the manually loaded variant. The cause of this phenomenon is probably the lower amount of damage and distorsion, that effects the preloaded IOL. The positive mean error in Group B suggests, that the IOL constants of Bi-flex 877FAB need to be corrected.

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