Eyeworld

Contact information Donnenfeld: ericdonnenfeld@gmail.com Contact information Name: by Eric Donnenfeld, MD EyeWorld Chief Medical Editor MAY 2019 | EYEWORLD | 3 I n the course of my career in ophthal- mology, I have seen intracapsular cat- aract surgery give way to extracap- sular surgery then phacoemulsification, the routine use of intraocu- lar lenses, pars plana vitrectomy, the exci- mer laser, and a pharmaceutical treatment for macular degeneration. The list could go on indefinitely. No field of medicine has benefited from innovations in medical technology more than ophthalmology, and the recipients of these advancements have been our patients. Medical technology is an all-encom- passing term that includes every aspect of innovation in our field, including advance- ments in pharmaceuticals, information technology, and diagnostic and therapeu- tic devices. Most of these advances have been accomplished through a synergistic relationship between industry and oph- thalmologists that has fueled innovation. The innovations, in turn, have given phy- sicians tools to better diagnose and treat our patients. Many technological advances have come from areas outside of medicine. In- novations in aspheric and diffractive IOLs are rooted in optical advances designed to improve telescopes and cameras. Before it was applied to the cornea, the excimer laser was developed by IBM to etch mi- crochips for computers. Then there's in- formation technology. With the increased use of electronic health records (EHR), telemedicine, and mobile technol- ogies like tablets and smartphones, physicians and patients both see the benefits that these new medical tech- nologies bring. For instance, physi- cians now have access to any type of information they need—drug infor- mation, research and studies, patient history or records, and more—within seconds, wherever they are, thanks to mobile devices. It is now rare to need to reference a book when a smart- phone can provide the answers within seconds. One of the main benefits in oph- thalmology of information technol- ogy has been the integration of new devices with diagnostic and guidance systems to help improve patient outcomes in cataract surgery, vision correction, IOP reduction, and drug delivery options. I think we can antic- ipate even more accuracy and safety in procedures thanks to continued innovations in the field. Technological innovations in ophthalmology and in the healthcare industry generally continue to provide physicians with new ways to improve the quality of care delivered to our patients and, indeed, healthcare around the world. Technology & innovation in ophthalmology © 2018 Novartis 1/18 US-RES-17-E-3227 References 1. Alcon Data on File (Jul 2016). 2. AcrySof ® IQ ReSTOR ® +2.5 D Multifocal Toric IOL Directions for Use. 3. Vega F, Alba-Bueno F, Millán MS, Varon C, Gil MA, Buil JA. Halo and through-focus performance of four diffractive multifocal intraocular lenses. Invest Ophthalmol Vis Sci. 2015;56(6):3967-3975 (study conducted with corneal model eye with 0.28µ spherical aberration). 4. Wirtitsch MG, Findl O, Menapace R, et al. Effect of haptic design on change in axial lens position after cataract surgery. J Cataract Refract Surg. 2004;30(1):45-51 5. Visser N, Bauer NJ, Nuijts RM. Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg. 2013;39(4):624-637. 6. Potvin R, Kramer BA, Hardten DR, Berdahl JP. Toric intraocular lens orientation and residual refractive astigmatism: an analysis. Clin Ophthalmol. 2016;10;1829- 1836. AcrySof ® IQ ReSTOR ® Family of Multifocal IOLs Important Product Information CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician. INDICATIONS: The AcrySof ® IQ ReSTOR ® Posterior Chamber Intraocular Multifocal IOLs include AcrySof ® IQ ReSTOR ® and AcrySof ® ReSTOR ® Toric and are intended for primary implantation for the visual correction of aphakia secondary to removal of a cataractous lens in adult patients with and without presbyopia, who desire near, intermediate and distance vision with increased spectacle independence. In addition, the AcrySof ® IQ ReSTOR ® Toric IOL is intended to correct pre-existing astigmatism. The lenses are intended to be placed in the capsular bag. WARNINGS/PRECAUTIONS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling for each IOL. Physicians should target emmetropia, and ensure that IOL centration is achieved. Care should be taken to remove viscoelastic from the eye at the close of surgery. The ReSTOR ® Toric IOL should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. Some patients may experience visual disturbances and/or discomfort due to multifocality, especially under dim light conditions. A reduction in contrast sensitivity may occur in low light conditions. Visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. Spectacle independence rates vary; some patients may need glasses when reading small print or looking at small objects. Posterior capsule opacification (PCO), when present, may develop earlier into clinically significant PCO with multifocal IOLs. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon informing them of possible risks and benefits associated with the AcrySof ® IQ ReSTOR ® IOLs. Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS ® or BSS PLUS ® Sterile Intraocular Irrigating Solutions. ATTENTION: Reference the Directions for Use labeling for each IOL for a complete listing of indications, warnings and precautions.

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