Borkenstein & Borkenstein
Research & Laboratory
Science & Innovation
In addition to our daily clinical work with patients, research represents a second key focus of our activities. Within the framework of Borkenstein & Borkenstein Research & Laboratory GmbH, we are engaged in basic research, the performance of specialized analyses and evaluations, as well as participation in multicenter studies both nationally and internationally. A central part of our work involves the investigation of intraocular lenses on the optical bench, where optical properties and material behavior are tested under standardized conditions. These activities are frequently carried out in close collaboration with universities, research institutions, and specialized laboratories.
Beyond this, we work closely with various industry partners to develop new ophthalmic devices and technologies, including injector systems, intraocular lenses, surgical instruments, and viscoelastic materials. The combination of clinical experience, scientific methodology, and technical expertise enables us to actively shape innovation. One current area of research is personalized medicine in ophthalmology. For example, we have developed new calculation models for a more precise determination of the individual vitreous volume—an approach that may help further optimize risk–benefit assessments for different treatment strategies in the future.
Innovative concepts arising from our projects have already resulted in patent developments, supporting the advancement of modern ophthalmic technologies and therapies. In addition, we maintain close scientific exchange with experts worldwide to rapidly translate new insights into clinical practice and ensure the highest standards of patient care. All of these activities are systematically coordinated within Borkenstein & Borkenstein Research & Laboratory GmbH, which serves as a competence center for applied research, innovation, and international collaboration. In recognition of this work, the company has been awarded the ACR Innovation Award by the Austrian Federal Ministry (Austrian Cooperative Research).
Further examples of completed projects can be found under “Publications”, as well as reports on our collaborations with Graz University of Technology.
Recently Completed Projects
Assessing Particle Release from Intraocular Lenses
One particularly exciting study was conducted for the first time worldwide in this form, as part of a research collaboration between our group and Graz University of Technology. Intraocular lenses (IOLs) are among the most frequently implanted medical devices and often remain in the eye for decades. At the same time, general awareness of microplastic contamination is increasing, raising the question of whether medical implants may release particles within the body. In this study, seven different IOL types were examined over a 30-day period under laboratory conditions to assess potential particle release. Three complementary methods were applied: OptoFluidic Force Induction (OF2i) as a novel technology for continuous particle counting, as well as μ-FTIR-ATR and μ-Raman microscopy for chemical identification of particles.
The results are highly reassuring for both clinicians and patients: throughout the entire observation period, no relevant particle release from the IOLs themselves was detected. Neither an increase in particle counts was observed using OF2i, nor could any of the more than 500 analyzed particles be attributed to IOL material. Interestingly, microplastic particles originating from packaging materials (PE, PP) were identified. These findings support the high material stability of modern IOLs. Future studies should include longer observation periods or accelerated aging models (thermal, UV, oxidative conditions) to more closely simulate long-term in vivo scenarios. In addition, these data are shared with major manufacturers, potentially contributing to further improvements in packaging quality in the future.
Geometry of Modern Presbyopia-Correcting Premium Intraocular Lenses
One project examined in detail the geometry of modern presbyopia-correcting premium intraocular lenses and their behavior within the capsular bag under different anatomical conditions. The shape of the haptics (supporting elements used for fixation in the eye) and the structure of the optic–haptic junction can decisively influence how stable a lens is positioned in the eye—both immediately after surgery and in the long term. To better understand these mechanisms, various intraocular lenses were analyzed using high-resolution computed tomography. Initially, all lenses were scanned in a dry, uncompressed state to precisely measure geometry, material thicknesses, and optic–haptic junction (OHJ) dimensions. Subsequently, the IOLs were compressed to varying degrees to evaluate the contact behavior between the haptics and a simulated capsular bag.
Clear differences were observed: optic thicknesses, OHJ volumes, surface areas, and lengths of contact zones varied considerably between models. These results demonstrate that certain IOL geometries may offer advantages or disadvantages in different eyes depending on the individual anatomical situation. A simple classification into “better” or “worse” is not possible, as many additional factors play a role in clinical practice. However, the study highlights the importance of detailed knowledge of IOL geometry in order to select the best possible lens for each individual patient.
Optical Properties of New Refractive Enhanced Depth-of-Focus (EDoF) Intraocular Lenses
Another project investigated the optical properties of new refractive Enhanced Depth-of-Focus (EDoF) intraocular lenses on an optical bench. The objective was to obtain objective measurement data on the extent of the visual range (depth of focus), the stability of visual acuity across different defocus ranges, and the wavefront patterns generated by the optics. For this purpose, modulation transfer function (MTF) measurements were performed both through frequency and through focus—evaluating image quality at different spatial frequencies and focal settings.
In addition, simulations of the expected visual acuity were calculated. Measurements were conducted under different pupil sizes (3.0 mm and 4.5 mm) to closely reflect real-life conditions. Higher-order optical aberrations were also analyzed to better understand the functional principles of the optics. These results are important to provide physicians with reliable laboratory data rather than relying solely on manufacturers’ marketing materials. Numerous similar optical bench analyses of new IOLs have been conducted.
Nd:YAG Laser Capsulotomies
Several additional laboratory studies examined how Nd:YAG laser capsulotomies—the gold standard treatment for posterior capsule opacification—can affect the image quality of modern presbyopia-correcting intraocular lenses when applied inaccurately. Because premium IOLs with diffractive zones or complex optics are particularly sensitive to surface defects, various lens types were evaluated. The investigation included surface analyses, USAF resolution and contrast tests, spectral transmission measurements, and through-focus contrast measurements.
After baseline measurements, seven YAG pits were deliberately created within the central 3.5-mm zone, and all measurements were repeated. The results showed that YAG pits significantly reduced image performance in all tested lenses. Image contrast levels decreased to 66%, 64%, 60%, 52%, and 59%, respectively. Light transmission also declined—depending on the lens—to 88%, 87%, 92%, 79%, and 91%. The spectral range between 450 and 800 nm, which is particularly relevant for everyday vision, was especially affected. USAF charts confirmed a clear reduction in optical image quality.
The study therefore demonstrated that Nd:YAG laser treatments on premium IOLs must always be performed with the utmost care to avoid microscopic damage and subsequent deterioration of visual quality. When performed correctly, however, no damage occurs and visual performance improves.
Drug Dosage in Intravitreal Injections
Another innovation focused on a largely overlooked issue: although personalized medicine has become the gold standard in many areas, the dosage of intravitreal injections in ophthalmology is still not precisely adjusted to the individual vitreous volume. Textbooks and registration studies typically assume a generalized vitreous volume of approximately 4–5 ml, despite the fact that actual vitreous volume can vary considerably depending on eye length and globe size. The aim of this more than five-year project and study was therefore to develop, for the first time, a reliable model to calculate individual vitreous volume. In this retrospective analysis, eyes were evaluated that had both orbital MRI examinations and biometric measurements (axial length and anterior chamber depth). By segmenting the MRI data, the actual vitreous volume was determined using voxel integration. From these values, a practical formula was derived to calculate vitreous volume more accurately based on axial length, including a correction factor accounting for anatomical differences across eye lengths. The results revealed substantial differences: emmetropic eyes typically have a volume of 4.5–5.5 ml, whereas myopic eyes often reach 9–10 ml, and highly hyperopic eyes may have only 3–4 ml. Using the new formula—VIVEX—surgeons worldwide can now quickly and easily determine individual vitreous volume. Following further clinical studies, this knowledge may help optimize intravitreal drug dosing, reduce side effects, and/or increase therapeutic efficacy. Multicenter studies are already planned to further investigate the impact of personalized dosing. Numerous studies have already cited our patented calculation formula—VIVEX—for individualized vitreous volume. A highly promising topic for further improving quality in ophthalmology.
New Surgical Techniques
Peer-Reviewed Publications and Scientific Literature
Borkenstein & Borkenstein regularly publish the results of studies, evaluations, and scientific analyses in international, peer-reviewed journals. The work covers a broad spectrum of modern ophthalmology, ranging from materials science laboratory studies and optical bench studies to clinical research, innovative surgical techniques, and approaches to increasing patient safety. The aim is to make a continuous contribution to the advancement of ophthalmological knowledge and to the improvement of patient care.
