WOC-Abu Dhabi-16-20 feb-2012-Experience with Preloaded IOLs

1. Dr. Mazhry FRCS, FCPS
Experience with
Pre Loaded IOLs
Dr. Zia-Ul-Mazhry
FCPS(Pak),
FRCS(Edin),
FRCS(Glasgow),
CIC Ophth- (UK)
Asstt Professor
Central Park Medical College Lahore
Consultant Eye Surgeon &
Head of Department
Wapda Teaching Hospital Complex
Lahore
Pakistan
Financial Disclosure
I have no financial interests or
relationships to disclose.

2. Dr. Mazhry FRCS, FCPS
The 123 PhysIOL
The Lens

3. Dr. Mazhry FRCS, FCPS
123 Insertion System

5. Dr. Mazhry FRCS, FCPS
Patients and Methods
 Inclusion:
 Age ≥ 50 years
 Senile or pre-senile cataract
 Capsular bag implantation
 Intraocular lenses from +10 to +30 diopters
 Potential of corrected visual acuity ≥ 0,6 afer surgery
 Exclusion:
 Amblyopia
 Monophthalmia
 History of intraocular surgery in the year before
 Sequelae of ocular trauma
 Marked microphtalmos or aniridia
 History of corneal endothelium damage (caustic burning, herpetic keratitis, cornea
guttata)
 Astigmatism ≥3.00 diopters
 IOP ≥25 mmHg with or without treatment
 Eye disease affecting the visual function (progressive uveitis, diabetic retinopathy,
ARMD, macular dystrophy, retinal detachment, glaucoma, optic neuropathy)
 Distant patient or difficulty travelling, which makes the clinical follow up difficult
 Patient involved in another clinical study

6. Dr. Mazhry FRCS, FCPS
Patients and Methods
 Exclusion due to peroperative
complications:
 Capsulorhexis tear
 Rupture of the posterior capsule
 Vitreous loss

7. Dr. Mazhry FRCS, FCPS
Study Parameters
Pre-op Per-op Post-op1
(D1 – D15)
Post-op 2
(M1 – M3)
Uncorrected VA   
Best corrected VA  
Refraction  
Intraocular pressure 
Anterior segment examination   
Fundus examination 
Incision size 
Aspect of the cornea 
IOL surface state  
IOL centration  
Aspect of the posterior capsule  

8. Dr. Mazhry FRCS, FCPS
Methods of Examination
VA Usual method
Refraction Usual method (sphere and cylinder in diopters, axis in degree)
Intraocular pressure Usual equipment (mmHg)
Anterior segment examination Slit lamp examination (normal/abnormal)
Fundus examination Usual method (normal/abnormal)
Incision size Usual instrument (tenth of a mm)
Aspect of the cornea Slit lamp examination (normal/abnormal)
IOL surface state Slit lamp examination (normal/abnormal)
IOL centration Slit lamp examination (centered/decentered)
Aspect of the posterior capsule Slit lamp examination (normal/abnormal)

9. Dr. Mazhry FRCS, FCPS
Ease of Insertion

10. Dr. Mazhry FRCS, FCPS
Lens Insertion Time(LIT)
 Time in seconds spent by the surgeon from holding the IOL and
its insertion device till placement of both haptics/ears in the bag
20
70
125
95
110
100
0 50 100 150
Phys 123
Acry SP
AMO TECH
Rayner SF
Rotho
Idea Exc
Seconds

11. Dr. Mazhry FRCS, FCPS
Review of the Study
IOL Injection Systems
IOL Type NO-
Eyes
IOL Cut SHC Cut SH Exc
Force
Centrati
on
Diff
unfold
Acrisof
SP,IQ,Res
100 1
(1%)
1
(1%)
- - +++ Comm-
on
Slimflex
123
50 - - - 2
(4%)
++++ rare
Rotho 100 2
(2%)
6
(6%)
4
(4%)
6
(6%)
++ rare
Rayner 50 1
(2%)
5 (10%) 6 (12%) 3 (6%) +++ rare
Idea 150 2 (1.3%) 8 (5.3%) 6 (4.8%) 8 (6.4%) +++ rare
Duration Jan 2007 to Dec 2008
SHC=superior Haptic Catch,

13. Dr. Mazhry FRCS, FCPS
Experience with PhysIOL 123
 Since the April 2008 to March 2010,
50 IOLs were implanted during
phacoemulsification cataract surgery. All
patients were between 50 and 80 years of
age (female – 29, male – 21).
 In the first 10 cases we used 3.2 mm
incisions. In the other 40 cases 2.75 mm clear
corneal incisions were utilized.

14. Dr. Mazhry FRCS, FCPS
Experience with PhysIOL 123
 The surgery went smooth, with no intra- or
postoperative complications. It was very
convenient to attach the cartridge with IOL
inside to the injector with one click and
without any additional manipulations. During
the implantation controlled smooth unfolding
was observed. We did not observe any
adverse effects related to the lens and/or the
injection system.

15. Dr. Mazhry FRCS, FCPS
Conclusion
 PhysIOL 123 preloaded IOL
system is a surgeon friendly IOL
Insertion system in terms of
safety, ease of insertion and
shortening of overall time spent in
the surgical procedure.

16. Dr. Mazhry FRCS, FCPS