Eyeworld

MARCH 2021 | EYEWORLD | 51 C Contact Cummings: abc@wellingtoneyeclinic.com Donnenfeld: ericdonnenfeld@gmail.com Garg: gargs@hs.uci.edu McCabe: cmccabe13@hotmail.com Vukich: javukich@gmail.com Most other major IOL manufacturers have been adding to their portfolio of preloaded IOLs in recent years as well. Dr. Donnenfeld said preloaded IOLs have an added level of stability and safety and make it easier on staff to transfer the lens to the surgeon. The quality and ease of the inserter, ac- cording to Dr. Cummings, can be an influential factor in use of the IOL. "In other parts of the world, I've heard of surgeons switching to a particular brand of IOL because the range has the same inserter. … Once you find an inserter that works well for you, it's easier, more repeatable," Dr. Cummings said. Despite updates in the IOL market to im- prove range of vision, optical quality, and ease of use, the physicians interviewed for this article emphasized that tailoring IOL decisions to pa- tient needs and setting appropriate expectations will continue to be important. "We're going to have more in-depth con- versations with patients and do more thorough preop evaluations, looking for patients who are good candidates and evaluate the distances achievable with these lenses," Dr. Donnenfeld said. "I think that with all these options, we need to determine which patient parameters are best for these lenses and consider demands for quality of vision versus quantity." "At the end of the day, it still comes down to picking the right technology for your patient and making sure they understand there is no perfect lens, and every lens has a positive and a drawback and that you discuss that with them," Dr. Garg said. "Do I hope we'll have a perfect lens for all patients one day? I do. Do I think we'll ever actually get there? I don't. I think we'll still need to make sure we're picking the appropriate technology for the patient." lens with haptics that flex as the ciliary muscle moves. In a departure from accommodating IOLs that work with the existing ciliary muscle, Alcon is working with Verily, a subsidiary of the Google-connected Alphabet, to develop an electronically driven IOL. Finally, Crystalens (Bausch + Lomb), which is approved in the U.S., was among the first in the category of accommodative IOLs to make it to market. Dr. Cummings said he thinks accommo- dating IOLs will make it to the market, but he admitted that it will take some time. "Will they replace all IOLs? I don't think so. It depends on the cost, size of the lens, how easy it is to insert the lens. I think the biggest challenge to accommodating IOLs is how well the other [advanced technology] IOLs have come along. … You'll have to go over and above with an accommodating lens to justify." New materials While companies are constantly working on IOL innovations, one area that doesn't see change very often is IOL material. One recent innova- tion that has been getting attention by oph- thalmologists on the material front is Clareon (Alcon, not yet available in the U.S.). Dr. Cummings described the Clareon mate- rial as "pristine" with no glistenings. "I think it surprised everyone how good this lens is. Everyone I know who is using it loves it. I think it's the highest quality lens that Alcon has produced," he said. More preloaded IOLs There has also been a push for more preloaded IOLs. Clareon, for example, comes as a preload- ed IOL with the company's AutonoMe delivery system. AutonoMe is an automated (gas-driv- en), single-use IOL delivery system. "You've got amazing control of the delivery," Dr. Cummings said of the system, adding that the Clareon material coupled with this delivery system makes it "the nicest lens I've used." continued from page 48

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