Fragmentation of the eye lens nucleus using a femtosecond (fs) laser to restore accommodation using "lens refilling"

Short description of the project

The natural aging of the eye lens leads to stiffening and clouding of the lens tissue. The stiffening of the lens interior becomes noticeable from the age of about 40 years by presbyopia. The formation of a cataract (cataract) occurs somewhat later, around the age of 50-60. Cataract surgery to treat cataracts is the most common surgical procedure in medicine. In 2020 alone, the number of artificial lenses (intraocular lens, IOL) implantations is estimated at 32 million worldwide. In this procedure, the cloudy lens is removed (phacoemulsification), and an IOL is implanted. The IOL provides clear vision but insufficient ability to accommodate. The so-called "lens refilling" (LR) method involves replacing the interior of the lens with a gel and has the potential to provide accommodation.

LR has not yet gained clinical acceptance because the method may involve two distinct complications. First, there is the risk of leakage of the injected material from the capsular bag. Second, there may be opacification of the lens capsule after surgery, resulting in stiffening of the capsular bag. The opacity obstructs vision, and the stiffening reduces accommodation, as the lens capsule is a driving force in this process. The proliferation of lens epithelial cells causes this in response to the loss of fiber cells.

In this joint development project of ROWIAK GmbH and Laser Zentrum Hannover e.V., the approach is to specifically remove only the nucleus of the crystalline lens and replace it with LR. The cortex (lens cortex) remains untouched in this new method of nucleus fragmentation so that the undesired effect of capsular opacification and stiffening could potentially be prevented. Thus, the restoration of accommodation ability after LR could be achieved. This project aims to develop and evaluate a method for the technical implementation of lens nucleus fragmentation.

The provision of this method will help to ensure that patients have a reduced risk of after-stare after receiving lens refilling, thus delaying or avoiding re-operation. In addition, accommodation is partially restored, eliminating the need to wear additional vision aids to correct presbyopia. This increases patient satisfaction, and the number of operations can be reduced.