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Strampelli Medal Lecture focuses on history and potential new developments of ICL

Issue: July 10, 2017

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MILAN — Predicting vault more accurately and controlling it over time would allow the STAAR ICL to be applied universally and replace many of the procedures performed in the cornea today, according to Roberto Zaldivar, MD, the Benedetto Strampelli SOI Medal Lecturer, at the OSN Italy meeting.

With only three cases of cataract in 16,000 implantations performed over the last 15 years, Zaldivar said that in expert hands this procedure should raise no fear of complications. The central hole of the AquaFlow model has further improved the safety profile, and there should be no concerns for older patients who will be using the upcoming presbyopic model.

Roberto Zaldivar

“In my three patients with more than 22 years of follow-up since AquaFlow implantation, vision is still amazingly good,” he said.

In his lecture, Zaldivar evoked milestones in the history of the ICL. In 1993 he performed his first implantation, in 1994 the AquaFlow was patented, in 1999 the V4 model was developed, and in 2001 the toric ICL entered the scene. The extended depth of focus model for the correction of presbyopia is underway and is going to appear soon, he said.

Sizing is still a weak point of the ICL, he said. A wrong vault can cause cataract, and with current methods of sizing, the spread of results is high.

“Vault is the most important thing in ICL. The lens has big tolerance in sizing, but you need to know how the vault works. What appears to be an adequate vault may no longer be so when the pupil constricts. People living in bright light conditions may have for a long time hypoxia in the capsule and develop cataract, even with the central hole,” Zaldivar said.

“I am very aggressive. If at any time I see there is inadequate vault, even on the day after surgery, I immediately change the lens. I do not allow the patient not to have circulation,” he said.

He foresees an application of electronics and smart technology in the eye in the future, for which the ICL will be the ideal platform. – by Michela Cimberle

Reference:

Zaldivar R. What is the best platform for the IOLs in the future? Benedetto Strampelli SOI Medal Lecture. Presented at: OSN Italy; May 26-27, 2017; Milan.

Disclosure: Zaldivar reports he is a consultant to STAAR Surgical.