Eyeworld

FEB 2014

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

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Patients deserve optimal visual quality and functional visual acuity in all light conditions C-flex ® Aspheric IOL with aberration-neutral technology: An IOL made from optically pure, superior quality material: 1. Kohnen T et al. Ophthalmologe 2008; 105(3): 234-40. 2. Nanavaty MA et al. JCRS 2009; 35(4): 663-71 3. Lyall DAM, Srinivasan S, Gray LS. Optom Vis Sci 2013; 90(9):996-1003. 4. Johansson B et al. JCRS 2007; 33: 1565-1572. 5. Altmann GE et al. JCRS 2005; 31(3): 574-585. 6. Erie JC, et al JCRS 2001; 27:614-621. 7. Rayner. Data on File. White paper. P Rayner C atients deserve optimal visual quality and functional - Rayner C flex Hydrophilic acrylic enhanced monofocal IOL atients deserve optimal visual quality and functional flex ® Aspheric Hydrophilic acrylic enhanced monofocal IOL atients deserve optimal visual quality and functional Aspheric Hydrophilic acrylic enhanced monofocal IOL atients deserve optimal visual quality and functional atients deserve optimal visual quality and functional P visual acuity in all light conditions C-flex Offers improved contrast sensitivity and visual acuity • compared with spherical IOLs Can offer 50% more depth of field than aberration-negative IOLs, by retention of the • atients deserve optimal visual quality and functional visual acuity in all light conditions flex ® Aspheric IOL with aberration-neutral technology: Offers improved contrast sensitivity and visual acuity compared with spherical IOLs Can offer 50% more depth of field than aberration-negative IOLs, by retention of the atients deserve optimal visual quality and functional visual acuity in all light conditions Aspheric IOL with aberration-neutral technology: Offers improved contrast sensitivity and visual acuity compared with spherical IOLs 1,2,3 Can offer 50% more depth of field than aberration-negative IOLs, by retention of the atients deserve optimal visual quality and functional visual acuity in all light conditions Aspheric IOL with aberration-neutral technology: , particularly in low light conditions Offers improved contrast sensitivity and visual acuity Can offer 50% more depth of field than aberration-negative IOLs, by retention of the atients deserve optimal visual quality and functional , particularly in low light conditions Can offer 50% more depth of field than aberration-negative IOLs, by retention of the Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration Less susceptible to the effects of tilt and decentration than aberration-negative IOLs • An IOL made from optically pure, superior quality material: • Low refractive index (1.46) of Ray ree from vacuoles and glistenings • F Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration Less susceptible to the effects of tilt and decentration than aberration-negative IOLs An IOL made from optically pure, superior quality material: • Low refractive index (1.46) of Ray ree from vacuoles and glistenings Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration Less susceptible to the effects of tilt and decentration than aberration-negative IOLs An IOL made from optically pure, superior quality material: • Low refractive index (1.46) of Rayacryl ® reduces the risk of glare ree from vacuoles and glistenings 7 Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration 4 Less susceptible to the effects of tilt and decentration than aberration-negative IOLs An IOL made from optically pure, superior quality material: reduces the risk of glare 6 Can offer 50% more depth of field than aberration-negative IOLs, by retention of the Less susceptible to the effects of tilt and decentration than aberration-negative IOLs 5 .com rayner ohnen T et al. Ophthalmologe 2008; 1. K 27 . Data on File. White paper :614-621. 7. Rayner .com ohnen T et al. Ophthalmologe 2008; 105(3): 234-40. 2. Nanavaty MA et al. JCRS 2009; 35 . . Data on File. White paper 35 AM, Srinivasan S, Gray LS. Optom Vis Sci 2013; yall D (4): 663-71 3. L AM, Srinivasan S, Gray LS. Optom Vis Sci 2013; 90(9):996-1003. 4. Johansson B et al. JCRS 2007; (9):996-1003. 4. Johansson B et al. JCRS 2007; 33: 1565-1572. 5. Altmann GE et al. JCRS 2005; 31 31(3): 574-585. 6. Erie JC, et al JCRS 2001; E W CORNEA 5 1 tal ametropia with an excimer laser and use the inlays to fix the age- related presbyopic changes either simultaneously or in a staged f ashion." The inlays are "extremely safe when placed properly," Dr. Maloney said, acknowledging there will be a small learning curve as surgeons adopt the technology. "The most difficult thing they'll face is inserting the inlay, releasing it, and centering it," he said. While h e predicts the inlays will command a large portion of the refractive mar- ket, he doubts they will become a strong add-on in cataract surgery. "Most surgeons will choose to use multifocal IOLs rather than implant- ing a monofocal lens and inlay into one eye," he said. People who are tolerant of monovision "are likely going to succeed with this technology," Dr. Slade said. "Over time as these be- come adopted into practices, I think we'll find the sweet spots in terms of t he perfect candidate." Dr. Waring concurred, noting treatments will be tailored "to the needs of the patient in terms of safety, optics, and lifestyle, in that order." Someone with a clear crys- talline lens who is not hyperopic is best served with a corneal-based solution, he said. Blended vision " works, and has worked for a long time. I envision that once available, inlays will be used much more often in the appropriate cases" as the inlays preserve distance vision in the non-dominant eye, provide full depth of focus relative to a fixed near point in blended vision, and stereovision is preserved relative to blended vision. "That's why these are so popular where they're approved outside the U.S.," Dr. Waring said. Outside the U.S. Surgeons in Asia and Europe are evaluating the inlays in combina- tion with laser vision correction, Dr. Maloney said, to simultaneously make patients emmetropic and treat presbyopia. Dr. Slade said "a few" physicians overseas are using multiple inlays, b ut that no U.S. investigator has real-world experience to be able to definitively predict which device will dominate market share (if any). "Some products we use the brand does not matter; I'm not sure if the inlays will fall into that cate- gory," he said. "I think some may do better than others, but we hope all the technologies succeed." Dr. Maloney said he's "excited about having one more tool to ad- dress refractive errors. When all you have is a hammer, everything starts t o look like a nail." E W Editors' note: Dr. Maloney is an investigator for AcuFocus and Presbia. Dr. Slade has financial interests with ReVision Optics (Lake Forest, Calif.). Dr. Waring has financial interests with AcuFocus. Contact information Maloney: rm@maloneyvision.com Slade: sgs@visiontexas.com Waring: georgewaring@me.com February 2014 50-55 Cornea_EW February 2014-DL2_Layout 1 1/30/14 10:41 AM Page 51

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