 Thank you for that wonderful talk. Next, we'll be having another Nameless Pathology Fellow, Jack Blee, talk to us about accommodating intraculatory lens that they're currently testing in a RAGF model, so please, help me welcome Jack. All right, good morning. My name is Jack Blee, and I'm a pathology research fellow working with Dr. Nameless and Dr. Warner, and today I'm gonna talk a little bit about a new accommodating intraculatory lens that we've been studying. This lens is developed by CORD LLC, and it is called the SC9 lens. Our research is supported by the Research to Prevent Blindness and Immigrant by CORD, and the authors here have no financial interests in this product. So first, for a little bit of background, the first intraculatory lens was implanted by Harold Ridley in 1949. He had experienced with British Flyers pilots who had sustained injuries when fragments of their cockpit became embedded in their eyes. When he noticed that the material, PMMA did not cause inflammatory reaction, he concluded that this material is inert, and he was actually, legend goes that he was inspired to create the first intraculatory lens when an inmate didn't actually ask them why he didn't replace the lens after a cataract surgery. Since that time, cataract surgery has become routine. About 4,000 to 6,000 per million operations are done each year, and advancements in material, in lens material design, and implementation technique has made, implementation technique has allowed this to give restore safe and effective distance vision. But there is a problem. After removal of the native lens and replacement with an artificial lens, the patient develops presbyopia, post-cataract presbyopia. And to tackle this problem of presbyopia after cataract surgery, we turn to development of intraocular lenses. There's two general strategy towards this. The first strategy is multifocal lenses. But with this strategy, there's a high risk of the patient's developing glare, halos, and loss of contrast sensitivity. The second strategy is accommodating intraocular lenses or AOLs. AOLs can change their position or shape to produce change in refractory power. There are two within this category. There's a single optic and a dual optic. Single optic AOLs rely on anterior movement of the lens optic with ciliary muscle contraction to generate increase in refractory power. Alternatively, the dual optic AOL has two optics that move in relation to each other to change refractory power. And here are two examples of the accommodating AOLs that I spoke of. The one on the left is the crystal lens. And today I want to present a novel single optic AOL designed by Cord called the SC9. This new lens is developed by Stuart Cumming, creator of the crystal lens and relies on the optic shift principle. The anterior movement of the lens optic with ciliary muscle contraction leads to an increase in refractory power. This lens is a single optic lens and it is meant as a requirement of the crystal lens. The study objective in our lab we're charged with assessing the safety and the stability of the lens in a guested bunny model. We do not test the function of these new lenses only the safety and stability, but we believe that before clinical studies could be done to assess accommodation, safety and stability must first be established. The study is ongoing, so today I'll present what we know at two months into the study. So the test article went into the right eye of the bunnies. Specifically, this is a posterior chamber lens, two plate haptics and it's made with silicone and polyamide. The change in design of the haptics is meant to improve stability within the capsular bag. The control lens is a silicone plate lens that is commercially available made by Star Surgical. We implanted the test and control lens into nine bunnies and the bunnies will be followed for six months and evaluated by Slitland examination. Rabbits were sacrificed at two months for histopathological examination. This is a six month study based up on the guidelines of the international organization for standardization. The surgery, including FACL, multiplication, NIL, implementation was performed by Dr. Mamelis. We conducted Slitland examinations periodically. Two rabbits were sacrificed at months two and the rest will be at month six and we used the Miyaki Apple view after inucleation to assess the globes and select lenses. We perform implant scatology on select lenses. And I also have a video of this surgery. This is an insertion of the lens. This is an insertion of the test lens and the control lens was inserted in a similar way. This was done through a three millimeter incision and of course the video is not sped up at all. And so we conducted Slitland examination to evaluate for a capsular biocompatibility and we did so at week one, four, and two months so far. The lenses were scored with a standard eye scoring method and tear capsular pacification and posterior capsular pacification were scored with Slitland and scored on a scale of zero to four. At week one, the test and control lenses were similar. Both had demonstrated mild inflammatory reactions, aqueous cell formation and fibrin formation. By week four we started to notice a greater difference. The degree of capsular bag or pacification was significantly higher in the control lens even by week four. By two months we observed increased proliferative material within the capsular bag in all eyes but we did observe a significant posterior capsule pacification formation that was much higher in the control eyes. And posterior scenicia formation, the test group, was less than that of the control group. We scored the level of PCO clinically at two months and used t-test to compare the scoring for the test and control group and there was a significant difference between the two lenses with a greater degree of capsular bag pacification in the control eyes. Next, after two months of following up we sacrificed two bunnies and conducted post-mortem examination. The Miyake Apple View allows us to evaluate the eyes from a posterior view with the lenses positioned within the caps. Likewise, in the post-mortem examination for the central and peripheral PCO and with summer rings formation there was a significant difference between the two lenses with a greater degree of capsular bag pacification within the control. In the next step we removed the test and control lens from the eyes, all globes were sectioned and histopathological examination was done. Neither test nor control and show signs of inflammation or toxicity. We evaluated the cytology of select lenses for both the test and control implants following a nucleation and removal of the lenses at two months. We were looking for surface reactions such as cellular reactions like giant cells, macrophages, cellular debris and fibrinous deposits. And this is important because this demonstrates UVO biocompatibility. A significant amount of proliferative material was noted on both control and test lenses. Both shows similar surface cellular reaction and thus similar UVO biocompatibility. So in summary, the UVO biocompatibility appeared to be similar for both the control and test lenses up to two months post-operatively and for the test lenses there appeared to be less posterior synache formation at two months examination. In terms of capsular biocompatibility for the test lenses, there appeared to be less capsular bagel pacification of the two months examination. We were going to finish the study in about four months and at this point, it appears that the test lens, the Accord SC9, accommodating intraocular lens, retained biocompatibility compared to that of the control lens. And we're looking forward to the result of clinical studies during which accommodation will be assessed. This is a lens we hope does not have to be explained because this would be extremely difficult to explain because the haptics are very busy. There's ridges, there's many loops and there's holes in there, so that's going to fix it well. So I think if you would have to remove this, you'd have to cut it at the haptic optic junction.