Vol. 30, Hors Série 2, 2007 113e Congrès de la Société Française d'Ophtalmologie

COMMUNICATIONS ORALES SYMPOSIUM EUROPÉEN

2S16

possible IOL for the case. All the opportune steps must be taken to prevent posteriorcapsule opacification.Conclusions: Identification of dominant eye is mandatory, since 35% of the popu-lation has one clearly dominant eye, usually in charge of providing good distancevision. Following a meticulous approach, clear lens exchange with multifocal IOLimplantation may prove to be a safe and reliable technique for the treatm.

060 SA-16.30Personnalisation de l’optique d’une LIO.Customised Optics for IOLs.CLAOUE C* (Essex, Royaume-Uni), CLAOUE CH (Londres, Royaume-Uni)

Introduction: The first IOL was implanted in 1949 without biometry and proved tobe the first refractive surprise and the first IOL explant. Since then, IOL technologyhas improved with measurements and calculations for defocus (spherical error) cor-rection, that means that the spherical refractive outcome is highly predictable.Aim: However, each eye is different, and we should now be moving towards perso-nalised IOL optics. Aspects that need consideration are astigmatism and presbyopiacorrection (lower order aberrations), and then higher order aberration correction.Material and methods: The question of 0.25 dioptre increments for IOLs hasbecome relevant with the introduction of Optical Coherence Tomography for axiallength measurements. Similarly, the use of Toric and Multifocal IOLs to correct cor-neal toric errors and presbyopia should become widespread. Manufacturers are nowoffering some personalised IOLs, but most have not yet moved towards individua-lised optics.Discussion: In addition to lower order aberration correction, a few manufacturershave made a start in higher order aberration correction with aspheric optics. Theterm is being used for a variety of optical treatments and needs careful examination.Furthermore, few manufacturers have so far combined correction to offer for exam-ple an IOL with a Toric, Multifocal, and Aspheric optic. Such an IOL is a real steptowards individualised optical correction.Conclusion: IOL manufacturers need to be challenged to produce more complexproducts.

061 SA-16.40Correction de la presbytie - l’enjeu de la prévention de l’opacification de la capsule postérieure.Correction of Presbyopia - Challenge for Prevention of Posterior Capsule Opacification.PRIGLINGER S* (Munich, Allemagne).

Introduction: Posterior capsule opacification (PCO) still remains one of the majorcomplications in cataract surgery. Problems especially emerge with the design ofaccommodative and multifocal intraocular lens (IOL). For proper function these IOLsrequire elastic lens capsules without any tendency of after cataract formation toavoid reduced mobility of the IOL and IOL decentration. Furthermore future conceptsof presbyopia correction such as injectable IOL materials also highly depend on elas-tic lens capsules without any capsule opacification.Material and methods: The most accepted concept of PCO prevention today isthe sharp edge design of an IOL. The sharp edge independently of IOL material caninhibit PCO development. Other current investigated strategies focus on the geneticand pharmacological manipulation of lens epithelial cells (LEC) or on the removal ofthese cells. A new in vitro PCO model for testing new strategies and substanceswhich could influence LEC growth will be presented. This model is based on thestabilisation of the capsular bag by a capsular tension ring (CTR). It offers excellentstabilisation of the capsule and physiological conditions in organ culture. Theinfluence of different CTRs on PCO was evaluated. We found, that CTRs do notcompletely prevent PCO development in vitro, however different CTR designs showdifferent shapes of capsule expansion and different pattern of LEC growth. Cysta-mine, ß-lactose and alkylphosphocholine, all antiproliferative but non toxic substra-tes were tested: Although none of the substances evaluated could fully prevent LECmigration in the in vitro PCO model, ß-lactose and alkylphosphocholine were highlyeffective in delaying LEC migration on the capsule bag when compared to untreatedLEC. In a third approach the laser photolysis system of A.R.C Laser® was adaptedfor capsule polishing by ablation of LEC. After cataract extraction multiple laser pul-ses were applied to mechanically remove LEC. The lowest efficient energy necessaryfor removal of LEC was evaluated in the in vitro model.Conclusion: The introduced in vitro model offers an easy and safe way to investigatethe impact of innovative approaches on PCO prevention.