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Acriol phakic IOL combines tradition, innovation
A large PMMA optic and an original three-point haptic design provide perfect stability, according
to the IOL’s developer.
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FLORENCE, Italy – A new anterior chamber phakic IOL combines tradition and innovation, with a large rigid PMMA optic and an original three-point haptic design, according to the surgeon who designed it.
Albino Rapizzi, MD, presented his Acriol lens (Soleko SpA) at the Italian Ophthalmologic Society meeting here. The lens is not commercially available.
“I have implanted all types of anterior and posterior chamber phakic IOLs, and in this lens I wanted to sum up what I thought were their best characteristics and, at the same time, minimize the problems,” he said. “I am satisfied because I have obtained what I wanted: perfect centration, long-term stability, no risk of endothelial damage and optimal visual performance in terms of quality of vision.”
Three-point angle fixation is designed to maximize stability. | The Acriol IOL is constructed of rigid PMMA with a novel design. |
Choosing the best
Prof. Rapizzi said he chose an anterior chamber implant because these lenses have been used longer than posterior chamber lenses, and results are therefore more reliable. The advantages of posterior chamber lenses have never been proved, he said, while complications are well documented.
“Moreover, an implant that is visible is more reassuring and controllable,” he added.
A traditional, rigid material such as PMMA should not be considered a drawback of the lens, he said.
“I deliberately didn’t want a foldable lens, because I believe the disadvantages of phakic foldable implants outweigh their advantages,” Prof. Rapizzi said. “Even though the incisions are smaller, when you introduce a lens that is rolled up, you create a round opening that easily lets the viscoelastic flow out, with consequent flattening of the anterior chamber. Also, when the lens unfolds in the eye, it inevitably produces some contact with the endothelium and the iris.”
A lens that is introduced flat into the eye has none of these disadvantages; it slides in like a coin through a slot, with no trauma to endothelium and iris, he said.
According to Prof. Rapizzi, the larger incision is not a problem.
“An experienced surgeon knows very well how to perform and suture a 5-mm tunnel without inducing astigmatism,” he said.
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Perfect stability
The three-point angle fixation of the Acriol provides a firm, stable holding, “just like a three-legged table,” Prof. Rapizzi said. Forces are equally distributed, with less tension on single points, resulting in perfect centration of the IOL, he said.
The asymmetric, oval section of the haptics optimizes their lateral flexibility and at the same time increases their vertical resistance. The design guarantees stability without lateral stretching and pupil ovalization, he said.
“The lens fits very nicely into the eye, with a perfect proportion between optic diameter and haptic length,” he said.
The current design is the result of progressive improvement upon three previous prototypes, from which problems and defects have been eliminated step by step, according to Prof. Rapizzi. He said the most difficult step was finding the appropriate measurements for the vaulting of the lens. The 0.9-mm vaulting of the latest design fits all eyes, including shallow 3.2-mm anterior chambers, he said.
Easy implantation
Implantation of the Acriol is easy, Prof. Rapizzi said.
“It is inserted horizontally. Using a hook, a gentle pressure is made on the proximal loop to slightly lift the distal loops over the iris plane. In this way, the lens slides easily and smoothly into the angle. Accurate maneuvers and the use of a cohesive viscoelastic make it practically impossible for the lens to capture the iris,” he said.
In 15 months, Prof. Rapizzi has implanted 22 Acriol lenses. While one pupillary block and one case of lens rotation occurred with the first prototypes, no complications were reported with the latest design.
The implant is now undergoing a clinical trial with a new group of surgeons, and shortly after will be commercially available, he said.
For Your Information:
- Albino Rapizzi, MD, can be reached at Centro Laser Veneto, Via De Carlo 1, 31100 Treviso, Italy; 39- 0422-422492; fax : 39-0422-424350 ; e-mail: albino.rapizzi@tin.it or claser@tin.it. Dr. Rapizzi has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.
- Soleko SpA, makers of the Acriol IOL, can be reached at Via Ravano, 03037 Pontecorvo (Frosinone), Italy; (39) 077-677-091; fax: (39) 077-677-0952; e-mail: posta@soleko.it. Web site: www.soleko.it.