Eyeworld

46 | EYEWORLD | MARCH 2021 ATARACT C continued from page 45 Experience with a new next generation monofocal IOL Johnson & Johnson Vision announced FDA approval and subsequent commercial launch of the TECNIS Eyhance and TECNIS Eyhance Toric IOLs in early February. These next generation monofocal IOLs are said to provide good distance vision and offer some patients extended intermediate and near vision. Douglas Koch, MD, implanted the first Eyhance IOLs outside of the clinical trial in the U.S. and shared his thoughts and experience thus far. "[These IOLs are] exciting because they give superb quality of distance vision with no increased glare, and they provide patients, on average, with an additional line of intermediate and near vision," Dr. Koch said. When he spoke with EyeWorld, he had just implanted four Eyhance IOLs. Three of his patients were targeted for distance; on postop day 1, uncorrected acuities were 20/20, J2 intermediate for two and 20/25 J5 intermediate for the third. The fourth patient was targeted for –0.75 and was 20/30 and J2 near on postop day 1. These results, Dr. Koch said, "are consistent with what we know about this lens from the optical bench data and the feedback from our European colleagues—that it truly expands the depth of focus." One study Dr. Koch thought was particularly powerful was by Auffarth et al., who reported that sig- nificantly more Eyhance patients had no difficulty with seeing to walk on uneven surfaces compared to monofocal controls (ZCB00, Johnson & Johnson Vision). 1 "With standard monofocal IOLs, some patients targeted for distance can see their cellphone and computer. Eyhance will increase this number significantly," Dr. Koch said. He also highlighted the larger landing zone with this IOL. "We may find a higher percentage of patients hit 20/20 or 20/25 uncorrected for distance as well. There is about a half diopter landing zone, which is larger than with standard monofocal designs," Dr. Koch said. How does Eyhance achieve these outcomes? Dr. Koch said the lens has a continuous aspheric surface for gradual steepening in the center without specific zones. Dr. Koch said that IOL calculations with this lens are the same, with the same A constant as the ZCB00. When it comes to aiming for a lens that goes to –0.4 D or –0.1, he said he would pick the latter more frequently with Eyhance. Dr. Koch doesn't see any conditions as contraindications with this lens. "I am going to be comfortable implanting this in my patients with ocular pathology because the quality of vision is superb. There isn't the compromise of dividing the light as you would see with any of the extended depth of focus or multifocal/trifocal designs," he said. Eyhance is billed as a monofocal lens, which means it doesn't cost the patient out of pocket, Dr. Koch said. Reference 1. Auffarth G, et al. Clinical evaluation of a new monofocal IOL with enhanced intermediate function in patients with cataract. J Cataract Refract Surg. 2021;47:184–191. Relevant disclosures Koch: Alcon, Carl Zeiss Meditec, Johnson & Johnson Vision Contact Koch: dkoch@bcm.edu continued on page 48

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