Ophthalmology Lectures: Usually we are caring about the power of IOL ..Now we are thinking Of IOL Design .

1. IOL IN
ANOTHER WAY
Dr.DIYAR JK
C.A.B (Oph.),F.I.C.O

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6. IOL : HISTORICAL VIEW
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IOL GENERAL CRITERIA
Overall design 3 piece/1 piece
Overall length 10–13 mm
Optics material Rigid (PMMA), flexible (silicone), foldable
(hydrophobic acrylic, hydrophilic acrylic), Collamer
Refraction index 1.42–1.55
Optics shape Biconvex, plano-convex, meniscus
Optics diameter 5–7 mm Optics design Spherical,
aspheric, toric multifocal, multifocal toric
Optics color Transparent, tinted
Haptics properties 3 piece/1 piece (PMMA, PVDF,
polyamide, 2, 3, 4, 6 haptics)
Type of implantation Injectable, not injectable
Type of packaging Pre-loaded, not pre-loaded7

8. OPTIC MATERIAL
HYDROPHILIC
ACRYLIC
Poly HEMA &
hydrophilic acrylic
monomer
R.I1.43, 38% water
content
Small in dry state
Advantage: easy to
handle,less mechanical
/YAG damage,unfolding
fast
Disadvantage:higherPC
O,low resistance to
capsule contraction
HYDROPHOBIC
ACRYLIC
Copolymer of
phenylethacrylate&
phenylethylmethacrylate
R.I1.55
Advantage :
thinner,reduce rate of
PCO,greater resistance
to YAG capsulotomy
Disadvantage
:photopsia & glistening,
BSS package,
susceptible to
mechanical damage by
PMMA,SILICON
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Optics design
Spherical : it means the front surface is uniformly curved from the
center of the lens to its periphery induce minor optical imperfections
called higher-order aberrations (HOAs), which can affect quality of
vision, particularly in low-light conditions such as driving at night.. So
to overcome this…
Aspheric IOL : are designed to correct spherical aberration,
thereby increasing contrast sensitivity, match more closely the shape
and optical quality of the eye's natural lens, and thereby can provide
sharper vision — especially in low light conditions and for people with
large pupils.
The cornea has positive SA, which does not vary significantly with
aging. The corneal SA has been reported to be approximately +0.27
µm for a diameter of 6 mm.
Other design : toric . Multifocal .

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Optics diameter : usu.5-7 mm

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Transition headline
Let’s start with the first set of slides

14. ‐ Biconvex IOLs are the most common and for 90% or more of
our patients, either constant anterior refractive power with different powers
produced by curvature changes of only the posterior surface, or the reverse
‐ Meniscus IOLs : are required when the IOL power is very low or
even negative, like we would use in highly myopic patients with long axial
lengths. These IOLs behave very differently and they have wildly different A-
constants, it is 126.6 for the plus power and 103.6 for the minus power,
‐ Plano-convex IOLs : have an advantage in eyes with
silicone oil because the flat posterior surface of the IOL will limit the
refractive surprise when it is against the silicone oil in the vitreous cavity.
These IOLs are typically PMMA.
We always avoid the dreaded “S-sign” seen when the IOL is upside down
in the eye. But how does the refractive power of the eye change when it
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Optics shape : Biconvex, plano-
convex, meniscus

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16. Optics color : Transparent, tinted
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17. 1.UV filter lenses : L (200 _ 400 nm)This type of
IOL endeavored to simulate the crystalline lens of a
young patient
2.Violet filter lenses : block the visible spectrum of
the wavelengths from 400 nm to 440 nm,
3.blue filter lenses that block the spectrum between
440 nm and 500 nm.
The cut-off value considered the best for retinal
photoprotection is established at around 445 nm
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TYPES OF FILTERS

18. IOL with different wavelength cut-off filters were
designed, like the lenses with an orange shade &
a yellowish shade
Any spectral filter that reduces blue-green
phototoxicity causes an equivalent percentage
decrease in scotopic sensitivity.
Indeed, there are no IOL on the market that offer
a good compensation between retinal protection
and reduction in the blue light that reaches the
ocular fundus (photoreception)
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Optic Edge Design
 is known to influence the migration of LECs on the
posterior capsule.
The discontinuous sharp bend created by the
sharp optic edges of the IOL appeared to induce
contact inhibition of migrating LECs. Even though
the course of formation of the capsule bend remains
the same in all the IOLs, starting from the periphery
in the capsular bag and progressing circumferentially
toward the optic edges,
 This capsular bend creates a mechanical barrier
to the migration of LECs on the posterior capsule.
Therefore, the sharp optic edge design was found to
be more effective in the prevention of formation of
PCO compared with IOLs with round optic edges.

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21. HAPTIC DESIGN
1. Plate haptic
2. Loop haptic ( C - loop , J - loop , Modified C – loop , Modified
J - loop )
3. Plate - Loop
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22. Plate-haptic versus Loop-haptic IOLs. : With the plate haptic design
IOLs, a high rate of anterior capsule opacification (ACO) as well a high
rate of PCO (up to 65% in standard plate design) has been
reported This may lead to various forms of LEC fibrosis. The cellular
processes that may wrap around the haptics

23. Haptics properties
Material : PMMA, PVDF, polyamide,acrylic,
silicon
NO. of haptics : 2, 3, 4, 6 haptics.

24. HAPTIC ANGULATION
(planar & angulated)
the haptic angulation maximize the barrier effect to
migrating LECs by pushing the IOL backwards
 reduces the incidence of PCO by inducing a
pressure gradient over the posterior capsule
For Posterior champer lens : 10 deg. Anterior
angulation to keep the optic away from the pupil
For Anterior champer lens : posteriorly anngulated
lens to vault the IOL away from the pupil
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25. THANK
YOU