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Comparative analysis of implantation behavior of ozonated and non-ozonated hydrophobic acrylic preloaded IOL injection systems for the initial 100 cases, its long-term effect on glistening and capsular thickening, and its impact on visual function

Poster Details

First Author: B.Kashyap INDIA

Co Author(s):    B. Kashyap   B. Kashyap   N. Gadkar              

Abstract Details


Considerable controversies exist regarding the extent of impact on visual function due to glistening. Most of the earlier studies have reported that these changes did not influence the visual function. However, contradictory data exists for Contrast Sensitivity at higher spatial frequencies. The rationale of this study was to evaluate the Implantation Behaviour of Ozonated and Non Ozonated Hydrophobic Acrylic Preloaded Intra Ocular Lens Systems, its long-term effect on Glistening and posterior capsular thickening and its impact on Visual Function in the initial 100 cases.


This was a prospective, comparative study of 100 eyes who underwent uneventful Phacoemulsification procedure with IOL implantation at a tertiary eye care centre in India.


All patients were divided into two groups: - 1. Group 1: - Ozonated Preloaded IOL System 2. Group 2: - Non Ozonated Preloaded IOL System All surgeries were performed by a single experienced surgeon for approximately the same operating time. Any complications arising during insertion of IOL were recorded and analyzed. Any variance was removed from the list. The main Outcomes were grades of Glistening, Posterior Capsular Thickening, Post-Operative BCVA, Contrast Sensitivity (CS) expressed as Modular Function in Photopic and Mesopic Conditions at 7 days, 90 days & 2 years respectively.


Haptic Issues significant in group 2 p=0.0001, 95%CI (15.28 to 41.66). At 2 years, difference of occurrence of glistening is significant p=0.00001,95%CI(31.05% to 64.01%) Visual Acuity decrease not significant in Group 2 (mean= 0.93) as compared to Group 1 (mean=0.97) at 2 years, p=0.051, 95%CI(-0.00020 to 0.07700). Contrast Sensitivity decreased significantly at 2 years in group 2 in Photopic @ 10 cpd = (p=.000,95%CI (-0.0516 to -0.0171)), @ 15 cpd = (p=0.025,95%CI (-0.034 to -0.0023)) & Mesopic @ 10 cpd (p=0.004,95%CI(0.0113 to 0.0570)), @ 15 cpd (p=0.003,95%CI(0.0086 to 0.0397)) At 2 years, Yag-capsulotomy difference not significant p=0.6480, 95%CI(-8.2472 to 12.6196)


Vivinex had no haptic issues during implantation as compared to Ultrasert. No glistening was found in Ozonated Vivinex Preloaded System at three months. Glistening increased in both severity and incidence with time affecting the majority of implanted Non Ozonated Ultrasert lenses by 2 yrs, causing non-significant decrease in visual acuity but signficant decrease in Contrast Sensitivity in both photopic and Mesopic conditions at higher spatial frequencies i.e. 10 cpd and 15 cpd. Rate of Yag Capsulotomy was non significantly increased in non-Ozonated Ultrasert Lenses. These advantages make Ozonated Preloaded IOL’s highly desirable to surgeons, patients and health care agencies

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