Surgical experience with a redesigned, fully preloaded, hydrophobic acrylic intraocular lens in challenging cases of pseudoexfoliation syndrome, phacodonesis, and small pupils

Purpose: The purpose of this study was to describe our surgical experience and evaluate safety and postoperative outcomes of a fully preloaded, monofocal, hydrophobic acrylic intraocular lens (IOL) (CT LUCIA 611P) with a newly designed optic-haptic junction in severe cases of pseudoexfoliation (PXF) syndrome, phacodonesis, and small pupils. Setting: This study was conducted in Borkenstein & Borkenstein, private practice, Privatklinik der Kreuzschwestern Graz, Austria. Patients and methods: This study presents outcomes of 15 eyes of 15 patients implanted with CT LUCIA 611P IOL with improved optical properties and more rigid and wider optichaptic junction. All patients had advanced cataract and PXF syndrome, of which phacodonesis was detected in 12 cases and five cases had PXF glaucoma. All eyes had small pupils with no response to mydriatic drops, and the surgery was performed with the use of Malyugin ring. All eyes were targeted for a slight postoperative myopia (-0.25 to -0.50 D). Refractive outcomes were presented for 3 months follow-up, while adverse events were followed up for to 10 months. Results: The mean age of the study group was 78.3 years (from 68 to 86 years). Three months postoperatively, the mean manifest spherical equivalent was -0.35 D (from 0.00 to -1.00 D) and all eyes were within +/- 0.50 D of their preoperative target. No significant refractive shift or refractive surprise occurred during the follow-up of 10 months. Corrected distance visual acuity (CDVA) improved from the mean value of 20/50 preoperatively to 20/20 postoperatively. No intraoperative adverse events were noted. Postoperatively, six eyes presented with a slight decentration or tilt, which did not significantly affect postoperative refraction, CDVA, or patients' subjective visual symptoms. Conclusion: The IOL provided good surgical performance, excellent refractive stability, and predictable outcomes in patients with PXF syndrome. Further studies are necessary to evaluate long-term stability.