Eyeworld

EW REFRACTIVE SURGERY 102 March 2015 recommend multifocal IOLs. How- ever, there are 2 major disadvantages of the classic multifocal IOLs. The first is that intermediate vision is weaker than we would like. This is especially true with the older bifo- cal multifocal lenses, which have excellent distance and near vision, but a weaker intermediate distance. In my experience, patients often complain about this gap. We know that intermediate vision is critical for spectacle-free functioning. We use intermediate vision to cook, see the food on our plates, read labels in a store or supermarket, and work on a tablet or computer. True near tasks such as reading a newspaper or book have been declining in importance for many people. Instead, we read books and newspapers on a tablet or a desktop computer. The second disadvantage of multifocal IOLs is the potential for glare, halo, or other unwanted visual effects. Although these are usually mild and improve with neuroadap- tation, many patients are afraid of these side effects and unwilling to risk the chance that they might experience more severe glare and halo. I think the fact that the ex- tended range of vision lens provides a substantial improvement in the range of vision while still minimiz- ing undesired halos or glare will make it appealing to patients. Of course, the Tecnis Symfony also has limitations. With this lens, I cannot promise patients 100% reading capability without glasses because it does not extend the range of 20/20 vision all the way to the traditional reading distance of 40–45 cm. However, it extends the range of vision by about 1.0 D throughout the entire defocus curve, from near to far, providing mean acuity of 20/40 or better all the way to 40 cm. To improve a patient's near acuity, we have the option of micro-mono- vision. I like to correct the domi- nate eye for emmetropia and the nondominant eye for –0.50 D. This small gap is easily tolerated and does not cause the problems we typically associate with monovision, but it is just enough to improve visual acuity in the near range and allow most patients to read without spectacles. Just like multifocal IOLs, the quality of vision with extended range of vision lenses will suffer if there is residual astigmatism or residual sphere in the dominant distance eye, so it is important to have a plan for correcting corneal astigmatism. Ultimately, I think extended range of vision IOLs will prove to be an excellent option for our patients who want natural feeling, continu- ous vision, and who want to avoid visual side effects. EW Editors' note: Dr. Goes is medical director of the Goes Eye Centre in Antwerp, Belgium. He has no financial interests related to this article. Contact information Goes: frankjr@goes.be New lens continued from page 100 Beaver-Visitec International, Inc. | 411 Waverley Oaks Road Waltham, MA 02452 USA US patent # 8,900,136. Additional US and International patents pending. BVI, BVI Logo and all other trademarks are property of Beaver-Visitec International (BVI) © 2015 BVI For more information, call 1-866-906-8080 or visit us at www.beaver-visitec.com Come experience the latest innovation in pupil expansion rings at Booth #2421. If minimizing intraocular tissue trauma during pupil expansion is important to you… Visitec® I-Ring ™ Pupil Expander Satisfaction has been high, even among the CLE subjects, who are generally regarded as more difficult to satisfy because they have good vision before surgery. Very high percentages—98% to 99%—say they do not have any severe halo, glare, or starbursts, a rate that is compara- ble to what we see with monofocal IOLs. Of the limited number of sub- jects (7) that I enrolled in the study and have personally followed, none is wearing glasses at any distance. These are promising interim re- sults, and I look forward to the final results once all the subjects have reached 1-month follow-up. Finding its place At Goes Eye Centre, we have im- planted nearly every presbyopia- correcting lens on the market over the past 15 years, and we regularly

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