Eyeworld

109 EW FEATURE March 2015 Refractive options not good enough to be in patients' eyes." "To me, the ultimate goal is to find a solution that will enable us to get rid of multifocals," Dr. Koch said. "They're a wonderful interim solution with many happy patients, but they compromise vision a bit with regard to clarity and certainly with regard to halos and driving at night. With lenses like the Symfony on the horizon, I hope that we will at last have implants that adequately increase depth of focus with little or no visual compromise." EW Editors' note: Dr. Weinstock has financial interests with Alcon, B+L, and STAAR Surgical (Monrovia, Calif.). Dr. Koch has financial interests with Alcon and AMO. Dr. Henderson has financial interests with Alcon, AMO, and B+L. Contact information Henderson: bahenderson@eyeboston.com Koch: dkoch@bcm.edu Weinstock: rjweinstock@yahoo.com have some functional near vision for short-term vision such as reading the cell phone or looking at a price tag. However, without bilateral implantation, some patients may not feel that their uncorrected near vision is sufficient for longer-term reading. "The benefit of having one mul- tifocal IOL and one distance correct- ed monofocal IOL is that the patient truly understands the benefits of the multifocal IOL and is usually happy to have at least one eye that can read without glasses." Dr. Koch thinks that adoption of the mix and match technique will depend on the lenses available. "I think as our options expand, it will be tempting to do more mixing and matching, but we'll have to see," he said. "For example, when a lens like the Symfony comes out, which gives distance and intermediate and some near, one could implant that in the dominant eye, and for the non-dominant eye, one could decide whether or not to go for more near vision with a multifocal or perhaps more safely elect micro-monovision with the Symfony." Future of multifocals Multifocal IOLs—and presbyopia- correcting lenses in general—make up less than 10% of cataract sur- geons' annual volume, according to the 2014 ASCRS Clinical Survey. But if these new technologies can offer patients better visual outcomes and fewer unwanted effects, surgeons will gain more confidence and use them more often, Dr. Weinstock said. "The FDA focuses on safety and the efficacy, but in the real world it's about the outcomes and the patient happiness," he said. "Ultimately the patients and doctors decide whether or not the technology is prime time or whether it's something that is WHAT IF YOU COULD REDUCE BY HALF THE NUMBER OF PATIENTS THAT FALL OUTSIDE OF YOUR ASTIGMATIC TARGET? †,1 © 2014 Novartis 12/14 ORA14059JAD-C system with VerifEye system with VerifEye THE CATARACT REFRACTIVE SUITE BY ALCON THE CATARACT REFRACTIVE SUITE BY ALCON THE CATARACT PMS 7656 PMS 7540 With streaming intraoperative aberrometry data in the OR, you can more confi dently choose and implant toric IOLs while improving your astigmatic outcomes. 2 † Intended target is defi ned as within 0.5 D of targeted astigmatism. 1. Alcon data on fi le. 2. Compared to conventional (preoperative) calculation of cylinder power and axis. YOUR ASTIGMATIC TARGET? †,1 With streaming intraoperative aberrometry data in the OR, you can more confi dently choose and implant toric IOLs while improving your astigmatic outcomes. 2 toric IOLs while improving your astigmatic outcomes. 2 toric IOLs while improving your astigmatic outcomes. 2. Compared to conventional (preoperative) calculation of cylinder power and axis. Real-time surgical validation that can reduce the number of patients that fall outside the intended astigmatic target by more than 50%. †,1 system with VerifEye+ ™ VALIDATION: ORA ™ System Validation Map system with VerifEye+ ™ ALCON CATARACT REFRACTIVE DIAGNOSTICS Tecnis Symfony lens Source: Abbott Medical Optics

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