Eyeworld

68 | EYEWORLD | SPRING 2024 R EFRACTIVE by Ellen Stodola Editorial Co-Director About the physicians Sumit "Sam" Garg, MD EyeWorld Chief Medical Editor Vice Chair of Clinical Ophthalmology Medical Director Director of Technology Professor - Cataract, Corneal & Refractive Surgery Gavin Herbert Eye Institute University of California, Irvine Irvine, California R. Doyle Stulting, MD, PhD Chief Medical Officer Ocumetics Technology Corp. Founder, Stulting Research Center at Woolfson Eye Institute Professor of Ophthalmology, Emeritus Emory University Loudon, Tennessee John Vukich, MD Founding Partner Central American Ophthalmic Research Consultants Summit Eye Care Madison, Wisconsin George Waring IV, MD Waring Vision Institute Mt. Pleasant, South Carolina C reating a true accommodating lens has been a goal for some time in ophthal- mology. Several ophthalmologists dis- cussed some of the products currently in development in this space and what makes them unique. Juvene lens by LensGen This lens is in two parts, said Sumit "Sam" Garg, MD, with a capsule-filling haptic that has an optic in it and also a receptacle for the action part of the lens, which is a fluid lens. Basically, you put that into the capsular bag, and that maintains the capsular volume, Dr. Garg said. Inside that, in a two-part inser- tion, you place the fluid lens into the eye and then tab it into place. "There are three tabs, and you pop it into place and that's what supports the lens inside the eye," he said. The anterior membrane is deformable, and with accommoda- tive effort, it becomes steeper, which gives you the ability to get this range of vision—distance, intermediate, near. The Juvene lens is a silicone and non-dif- fractive lens. "Some of the limitations we have with the diffractive optics and presbyopia correction go away because it's non-diffractive, so you're not as concerned about other pathol- ogies," he said. "But on the flip side, you get monofocal-like optics with multifocal-like range, and the conversation becomes easier." Right now, when people talk about lenses, they usually talk about the great range achieved but rarely marry that with the visual quality per- formance, Dr. Garg said. "They'll say, 'I get great quality,' but don't talk about the range. This will allow us to do both at the same time, and because of the proposed mechanism of action, I think that's really intuitive for patients." Dr. Garg said the Juvene lens takes a bit of patient adaptation. "I think it takes a little while for the eye to get used to, at least what we've seen in initial trials," he said. "It's not necessar- ily like you put it in and the next day you have full range. Most people see improvement in near and intermediate over the first month or so, but really after 3 months is when it starts to kick in." The Juvene lens is not currently in an active trial but the company is ramping up for a Phase 1 FDA trial. All the data published so far has been in exploratory study outside U.S., Dr. Garg said, so it's a different patient population but favorable data. He added that data on the lens has been presented at the ASCRS Annual Meeting and has been published in the Journal of Cataract & Refractive Surgery. "We recently presented 3-year data at ASCRS [and] showed maintenance of magnitude of effect, so whatev- er accommodation you had at year 1, you saw at year 3," he said, adding that results were the same in respect to contrast sensitivity. What is seen with this lens is binocular summation, he said, so if you have it in both eyes, those patients as a whole did better than patients who just had it in one eye. "I think that's true of most of these lenses. This is not a monovision effect. This is a distance-corrected actual effect of the lens," Dr. Garg said. The incision for the Juvene lens is around 3–3.2 mm, Dr. Garg said, adding that "the only real learning curve with the surgery is getting used to the two-part insertion and tabbing it in the eye." In terms of safety, he said endothelial cell counts are similar to traditional surgery, and there hasn't been any major inflammation. You don't get significant PCO because the bag stays open, he said. "This is not just true of the Juvene; it's true for any of these lenses that keep the bag open." So far, the results have been promising with the published data, he said. JelliSee IOL by JelliSee Ophthalmics John Vukich, MD, has been working with the trial of the JelliSee IOL, which he said is a lens that is designed to mimic the natural lens of a child. In its resting state the lens will, by design, Current accommodating lenses in development The Juvene lens Source: Sumit "Sam" Garg, MD, and LensGen

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