Eyeworld

EW REFRACTIVE SURGERY 26 January 2015 by Lauren Lipuma EyeWorld Staff Writer mesopic conditions, reducing glare and halos. A toric version has been released recently, Dr. Gatinel said, that will have a diffractive face on the front surface of the lens and a toric face on the back surface. Simonetta Morselli, MD, chief of the ophthalmic unit, San Bassiano Hospital, Bassano del Grappa, Italy, discussed new and evolving lenses for microincisional cataract surgery (MICS). One such lens is the INCISE IOL (Bausch + Lomb, B+L, Bridgewater, N.J.), a 1-piece posterior chamber IOL made of an enhanced hydrophilic acrylic material. The INCISE lens utilizes advanced optics (AO) technology, Dr. Morselli said, that makes it free from spherical aberrations, less sensitive to tilt, and gives it an enhanced depth of field. The lens uses the same hy- drophilic HEMA and hydrophobic PMMA used in B+L's Akreos AO lens, but includes more of the hydropho- bic monomer, making it more stiff and resistant to tearing, Dr. Morselli said. The INCISE lens is inserted using a dedicated injector optimized Physicians discuss new possibilities in IOL technology at a recent meeting W ith IOL technology evolving rapidly, ophthalmologists can now offer spectacle in- dependence at a wider range of distances than ever before. A session at the 2014 APACRS meet- ing, "IOLs: The Jewel in the Crown," highlighted the latest advances in premium IOL technology and de- sign, focusing on IOLs that provide additional focal points and those that reduce unwanted visual effects. When it comes to offering a full range of vision, true accommodating lenses are the solution, but these lenses are not available yet, said Eric Donnenfeld, MD, clinical professor of ophthalmology, New York Univer- sity Medical Center, New York. "Accommodating lenses are the answer, but they just don't exist," Dr. Donnenfeld said. "If we had an accommodating lens, we wouldn't be having this conversation today." There are still several options for patients wanting spectacle indepen- dence. Dr. Donnenfeld described one such lens, the Tecnis Symfony extended range of vision IOL (Ab- bott Medical Optics, AMO, Abbott Park, Ill.). The lens is the first and only presbyopia-correcting extended range of vision lens, and allows for a continuous, full range of high-qual- ity vision. The lens is available in a non-toric and toric version and is currently in trials in the U.S. Tecnis Symfony IOL patients have experienced high levels of spectacle independence at far, intermediate, and near distances, Dr. Donnenfeld said, and patient satisfaction has been incredibly high—97% of patients said they would elect to have the lens im- planted again. Although patients do lose contrast sensitivity, some of that loss is gained back with propri- etary achromatic technology that corrects chromatic aberration. The lens has an incidence of halos and glare comparable to a monofocal IOL, according to study results. No significant additional chair time is needed, according to information from AMO. Different technology Damien Gatinel, MD, assistant pro- fessor and head of anterior segment and refractive surgery, Rothschild Ophthalmology Foundation, Paris, described the FineVision diffractive trifocal IOL (PhysIOL, Liege, Belgium), which combines 2 apodized diffraction patterns— one for distance and near and one for distance and intermediate—to provide patients with distance, intermediate, and near vision. Dr. Gatinel co-designed the lens. Intermediate vision became a daily need in the computer age, Dr. Gatinel said, and its need grew further with the introduction of tablets and smartphones. Coinciden- tally, the FineVision IOL came to the market in 2010, the same year that Apple (Cupertino, Calif.) debuted the iPad, he said. The FineVision lens is a hy- drophilic acrylic IOL with a blue and UV light filter that is inserted through a 1.8 mm incision. In addition to having 3 points of focus, the lens offers pupil-dependent focusing—the lens increases the light available for distance vision in Latest advances in premium IOL technology I OL innovation continues to advance the field of refractive cataract surgery. This year femtosecond laser-assisted cataract surgery has been center stage, but it has also been a great year for IOL technology. In the United States we are eagerly awaiting the FDA approval of the first multifocal toric IOL—the ReSTOR toric (Alcon, Fort Worth, Texas). In addition we expect to add two more multifocal IOLs from Abbott Medical Optics (Abbott Park, Ill.)—the Tecnis 2.75 and 3.25 D low add multifocal IOLs. Abbott Medical Optics has also recently completed its FDA trial of a brand new class of IOLs—the Tecnis Symfony extended range of vision IOL that provides distance and near vision with minimal glare and halo. In Europe new diffractive trifocal IOLs and small incision IOLs that can be inserted through sub-2 mm incisions are advancing our profession. All of these new IOL technologies offer our patients alternatives that enhance vision and improve quality of life. Eric Donnenfeld, MD, refractive editor Eric Donnenfeld, MD, explains the advanced optics of the Tecnis Symfony extended range of vision IOL. Refractive editor's corner of the world

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