Eyeworld

EW CATARACT 27 January 2019 840 Walnut St., Philadelphia, PA 19107 | willseye.org | 877.289.4557 Wills Eye Hospital brings together leaders of every subspecialty in ophthalmology. It's a special place where "Skill with Compassion" is not just our motto, it's at our very core, our guiding principle. The world's home for ophthalmology. Jerry A. Shields, MD Ocular Oncology Research highlight What these could mean for presbyopic patients F or presbyopic patients un- dergoing cataract surgery, a new option that may be at- tractive is the use of extend- ed depth of focus (EDOF) lenses, according to Viral Juthani, MD, assistant professor of ophthal- mology, Montefiore Medical Center, Albert Einstein College of Medicine, New York. Investigators took a look at EDOF lenses that are available worldwide in a review published in Current Opinion in Ophthalmology. 1 Current backdrop Before EDOF lenses, the options for spectacle independence after cataract surgery were monovision with monofocal lenses or use of multifocal or accommodative lenses, Dr. Juthani explained. He said there are three main disadvantages with multifocal lenses. "First is the loss of contrast sensitivity, and the second is the limitations associated with having fixed focal points because they result in fixed working dis- tances. Patients would say they see well at a distance, intermediate, and near point, but in between, they had diminished visual quality." Third, multifocal lens patients were reporting some photopsias such as halos, glare, and starbursts. The idea behind the lens was to improve the range of clear vision without fixed focal points while reducing photop- sias and loss of contrast sensitivity. The Crystalens (Bausch + Lomb, Bridgewater, New Jersey) was the main accommodative lens. "It has grown out of favor as studies have shown that the effects of accommo- dation tend to wear off over time," Dr. Juthani said. Emerging EDOF approaches The early stage review that investi- gators undertook summarized the current EDOF lenses available world- wide. Dr. Juthani said it is a big pic- ture look at studies describing visual outcomes and patient satisfaction. Currently, there are three dif- ferent types of EDOF lenses aimed at trying to provide more seamless near, intermediate, and distance vi- sion. Only one, the Tecnis Symfony (Johnson & Johnson Vision, Santa Ana, California), is FDA approved. by Maxine Lipner EyeWorld Senior Contributing Writer Close-up on extended depth of focus lenses "Instead of creating fixed focal points, they create a single elon- gated focal point to enhance the depth of focus for improved range of vision, and they focus incoming waves in an extended longitudinal plane as opposed to fixed points using modified diffractive optics," Dr. Juthani said. With the Symfony they tried to offset the limitations of having the elongated plane by correcting for chromatic aberration. continued on page 28

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