Novel accommodative IOL system may prevent PCO

A novel accommodative IOL system, teamed with an innovative capsular bag refilling technique, may be an answer to presbyopia and the prevention of posterior capsular opacification (PCO). Okihiro Nishi, MD, Nishi Eye Hospital, Osaka, Japan, introduced the concept during his presentation of the Charles D. Kelman Innovator's Lecture.

Dr. Nishi first described a theory of the pathogenesis of PCO in an eye receiving a sharp-edged IOL. He showed how lens epithelial cells may migrate before the capsular bend is formed by the IOL and in the case where the capsular bend formation fails.

To restore accommodation and prevent PCO, Dr. Nishi developed a dual-optic IOL system, which uses two lenses: one implanted after being inverted to seal the posterior continuous curvilinear capsulorhexis (CCC) and the other piggy-backed in the capsular bag. A silicone polymer is injected between the lenses through a hole. The lenses completely seal the CCCs and silicone cannot escape.

"The expected mechanism of accommodation occurs with forward movement of the IOL and steepening of the anterior curvature of the IOL," he said.