In recent years, with the acceleration of IOL research and development, some advanced IOLs have come into being, such as multifocal, adjustable, crystalline eye, and astigmatism-correcting IOLs. At the same time, ultrasound technology equipment has also developed greatly, such as twisting ultrasound and tiny incision coaxial technology, which are widely used in cataract ultrasound emulsification surgery. This article focuses on a review and outlook of these new technologies.
The use of multifocal IOLs has significantly improved near vision There are three types of multifocal IOLs that we currently use: ReStor (Alcon, FortWorth, Texas), ReZoom and Tecnis multifocal (AMO, SantaAna, Calif.).
Current adjustable IOLs are not yet satisfactory It has been reported that Crystalens can provide 1D more adjustment and 80% of patients can look at a computer without glasses, but only 27% can thread a needle and thread.
The best refractive lens currently in development is NuLens (NuLens, Israel), an adjustable lens that can provide more than 10D of adjustment, and up to 50D of adjustment in monkey eyes.
Prospects of IOLs for crystalline eyes There are three types of crystalline eye IOLs currently in use: atrial angle-supported, iris-clamped, and posterior chamber types.
IOLs for astigmatism correction have good prospects In the future, in combination with multifocal IOLs, it is also possible to correct presbyopia at the same time, so that patients can completely get rid of the dependence on frame glasses. For patients with high myopia and high hyperopia, toric IOLs also have great prospects for application.
Debate on Cataract Surgery Incision There is still a debate between two-handed and coaxial surgery for micro-incision. Both sides of the debate between two-handed micro-incision and coaxial micro-incision ultrasound emulsion surgery are confident. Both approaches are excellent in terms of stability of surgical operation, control of astigmatism, and visual acuity outcomes, with no one side having an advantage over the other. As ultrasound equipment improves, more surgeons are willing to choose the coaxial micro-incision procedure because there is no learning curve, it is easier to master, and the procedure is safer.
New advances in ultrasound emulsification technology equipment continue to be made There are three main ultrasound equipment platforms-WhiteStarSignaturePhacoemulsificationSystem(AMO), InfinitiVisionSystem(Alcon) and StellarisVisionEnhancementSystem(Bausch&Lomb).
The safest and most effective ultrasound emulsifier is Alcon’s Infiniti. AMO launched a new ultrasound emulsification system, Signature, in April 2007, which is not yet available in China.
Stellaris (StellarisVisionEnhancementSystem), a product launched last year by Dr. Lund, will be available in China next year and is intended to replace Millennium. the new device allows two-handed or coaxial microincision cataract surgery.? The coaxial micro-incision has a minimum incision of 1.8mm. The procedure is designed with a new emulsification head and a thinner cuff, and the 0.5mm ID needle can be used with a high negative pressure setting. The new fluid flow system (EQFluidicsManagementTechnology) ensures more stability in the anterior chamber.
Cataract refractive surgery has advanced rapidly in recent years due to continuous innovations in ultrasound emulsification equipment and IOL products. Improvements in ultrasound devices have improved hydrodynamic efficacy, anterior chamber stability and surgical efficiency, allowing for smaller surgical incisions. The introduction of several ultrasound systems with new technology has resulted in higher ultrasound efficiency and better patient outcomes. At the same time, the development and application of new IOLs will certainly enable thousands of cataract patients to obtain more perfect vision.