Assessment of a new hydrophilic acrylic supplementary IOL for sulcus fixation in pseudophakic cadaver eyes

PurposeManagement of refractive errors after cataract surgery includes spectacles or contact lens, secondary laser vision correction, intraocular lens (IOL) exchange, or piggyback lens implantation. We evaluated for the first time a single-piece hydrophilic acrylic IOL designed for supplementary sulcus fixation in postmortem pseudophakic human eyes.MethodsPseudophakic human cadaver eyes were imaged by anterior segment optical coherence tomography (AS-OCT) to assess position of the primary IOL. Eyes were prepared as per the Miyake-Apple technique. The supplementary IOL (Medicontur A4 Addon IOL family) was then inserted into the ciliary sulcus. AS-OCT and photographs from anterior and posterior views were used to assess IOL centration, tilt, and interlenticular distance from the primary IOL.ResultsData were obtained from 12 eyes having primary IOLs of varying materials and designs in the bag and representing different sizes of eyes and severity of Soemmering's ring formation. The A4 Addon IOL was successfully inserted into the ciliary sulcus and was well centered in all cases. Four cases of tilt were observed on AS-OCT: three with mild tilt due to pre-existing zonular dehiscence, and one due to a localized area of Soemmering's ring formation. Interlenticular distance ranged from 0.34 to 1.24 mm and was not dependent on severity of Soemmering's ring or type of primary IOL.ConclusionsThe A4 Addon IOL was designed for sulcus fixation as a supplementary lens, with a large diameter, a square-shaped optic, four smooth loop haptics, and a convex-concave optical surface. It exhibited appropriate centration and interlenticular distance with different primary in-the-bag IOLs.