JAN 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Looking at specific results of 188 subjects who were implanted in the non-dominant eye at the average age of 51, the range of errors spanned from –0.5 to 1.5 D. To judge the outcomes, Dr. Steinert said that the criteria for an excellent outcome was to be 20/25 or better uncorrected at all three distances: near, intermediate, and distance. "It's a higher bar than we've typically known for these types of corrections," he said. Results indicate that this goal is being accomplished in most patients, and it did not make a difference, he said, in terms of where in the range of –0.5 to 1.5 those patients fell. "The Raindrop provides uninterrupted visual function and patient satisfaction across a surprisingly wide range of preoperative refractive errors," Dr. Steinert concluded in his presentation. Further studies on the Raindrop and other factors to consider "As more results come in, particularly long term, refinements in power ranges are to be expected," Dr. Steinert said. Bilateral implantation is an exciting possibility for the future. "A large number of patients retain excellent distance vision while gaining intermediate and near at the 20/25 or better level at all three distances," he said. "In patients who achieve those results in the first eye, an implant in the second eye seems worth considering." He noted that pilot studies outside the United States are exploring this with caution. Patient selection for the Raindrop Dr. Steinert said the ideal patients for the Raindrop inlay would be "presbyopes who desire improved intermediate and near vision and who meet the other criteria." If the device was available in the U.S., he would be happy to recommend it to patients. "As with any device, the list of relative and absolute contraindications needs to be respected," Dr. Steinert said. Dry eye syndrome, often in conjunction with meibomian gland disease as well as aqueous deficiency, needs to be diagnosed and treated before refractive surgery is considered. Dr. Waring said patient selection needs to be considered when moving forward with the Raindrop and other corneal inlays. "Patient selection is still absolutely critical, and these are not devices that you would use therapeutically in any way," he said. Patients need to have a very healthy eye, he said, comparing the patient selection to that of a multifocal IOL. The patient needs to have minimal refractive error and astigmatism unless combined with an excimer treatment, the crystalline lens needs to be clear and the macula needs to be healthy, he said. The Raindrop is already in use in Europe. Dr. Steinert said approval in the United States will probably come in the next couple of years because of the multi-year follow-up requirements of the FDA. Moving forward, Dr. Waring said it will be important to gather even more information on the Raindrop and other inlays in development. The data so far is encouraging, but it's important to pay attention to long-term follow-up for safety and efficacy. EW Editors' note: Dr. Steinert has financial interests with ReVision Optics. Dr. Waring has financial interests with AcuFocus. Contact information Steinert: steinert@uci.edu Waring: waringg@musc.edu EyeWorld @EWNews Follow EyeWorld on Twitter at twitter.com/EWNews Find us on social media Are you a fan of EyeWorld? Like us on Facebook at facebook.com/EyeWorldMagazine

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