At the 2014 ESCRS Dr. Thomassen introduces MFR2 at Mediphacos speaker corner

1. The first 100
Experience with Mediphacos MF-R2 IOL from a private
practice in Denmark.

2. Financial affiliation
 I do not receive any financial support from any of the
producers mentioned in this paper.

3. Viborg Eyeclinic

4. Viborg Eyeclinic
 Private clinic, public remuneration for operations.
 +- 800 lens operations per year.
 Lasercenter, excimer
 1 ophthalmic surgeon, one cosmetic surgeon, 2
optometrists

5. Incitament for IOL change
 Danish government demands:
 Hydrophobic IOL
 Asphaeric optics
 Foldable IOL
 Acrylic material
 360’ square edge

6. My situation
 Prefer to not make wound assisted injections
 Prefer to inject the IOL into the capsule
 More controlled
 Not possible with the new demands from the
government and the existing IOLs in Denmark
 Needed to find a new hydrophobic IOL that could go
into the eye through my 2,2 mm incision.

7. My requirements
 The ideal IOL material must provide retinal protection
and combine positive features of hydrophobic and
hydrophilic acrylics.
 Has to go thrugh a 1.8 mm tip
 Not a new material

8.  Flexacryl
Mediphacos
 A unique copolymer
that combines
hydrophobic and
hydrophilic monomers.
It’s not a coated
hydrophilic IOL.

9.  Miniflex
Flexacryl IOLs
 Conventional S-shaped single piece
 Also a preloaded version
 MFR²
 Implantation improved plate haptic
design

10. Comparation
 I used both of them for a couple of months
 When injected through the same 1,8 mm tip, the MRF²
had the least resistance in my hands.
 MRF² is superior to Microflex as to ease of injection.
 I felt it was safe to inject the MRF² via a 1,8 tip.
 So I just started doing it……

11. Easy implantation

12. Operation
 Same surgeon
 Pre-op : Full examination incl. high resolution OCT,
biometry with Haag Streit Lenstar.
 Alcon Infinity, single 2,2 mm incision technique, pre-chop.
 Post.op. Tobradex [Alcon](Tobramycin +
dexamethasone) x3/day for 2 weeks+ Yellox
[Bausch&Lomb] (Bromfenac) x 2/day for 6 weeks.

13. Follow up
 1 week; BCVA, IOP and slitlamp
 1 month; BCVA, IOP, slitlamp + Lenstar
 Not started yet:
 6 months: BCVA, IOP, contrast, slitlamp + Lenstar

14. The first 89 eyes
 1 severe post.op. sterile uveitis (woman 58 yo)
 Resolved with triamcinalone intracameral.
 Visual aquity of 1,0 s.c. today
 1 post.op. CME, male 77 yo. Treated acc. to ESCRS protocol
 BCVA of 0.8 today
 No complications with injection procedure
 No problems with IOL placement in the eye.
 No physical damage to IOL to be seen
 28D IOL the highest diopter injected – no problems.

15. Result
 76 patient with BCVA minimum 1,0 in the operated
eye (all 5 letters on the Snellen chart 1,0)
 8 patients with BCVA from 0,8 to 1,0
 2 patients with BCVA from 0,5 to 0.80 (AMD)
 1 patient with BCVA 0.4 (ERF)
 1 patient with BCVA 0.15 (AMD)
 1 patient with BCVA <0.04 (atrophic AMD)

16. Complaints
 Dysphotopsia the first 3-4 weeks
 Color disturbances
 Photophobia for some weeks
 Floaters clearer than before the op.

17. Happy patients
 Fast operation
 Good VA in the afternoon
 Good eyesight, happy for the operation, insist on
having the other eye operated too.

18. My issue
 The lens is thin, reminds me af the B&L Akreos and
Aaren OptiVis.
 Long time stability in the capsule?
 Capsule contraction => movement of the IOL?

19. Hyperopisation
 Aaren OptiVis, some few IOLs tended to go towards
the plus side with ½D per half year.
 Slitlamp shows capsular contraction
 Forces the optic in a posterior direction and bends
the haptic up toward the pupil.
 YAG with limited effect.
 According to Medicophacos, this has not been seen
with the MRF²

20. The Alta study
Starts in January 2015
MRF² / Alcon AcrySof IQ implanted in
200 patients
Cataract, no co-existing ophtalmic
pathology.
1 year follow up.
VA, IOP, contrast, OCT and Lenstar
How does the lens compared to the
AcrySof as to standard measured
outcome? How stable is the IOL
compared to the AcrySof?