Eyeworld

75 EW INTERNATIONAL June 2016 Bausch + Lomb (Bridgewater, New Jersey) and PhysIOL. Dr. Kretz has fi- nancial interests with Alimera Sciences (Alpharetta, Georgia), Bayer (Leverku- sen, Germany), Novartis (Basel, Swit- zerland), Alcon, Abbott Medical Optics, Mediphacos (Belo Horizonte, Brazil), LENSAR (Orlando, Florida), Hoya Surgical Optics (Singapore), Sifi (Italy), Oculentis, PhysIOL, and Carl Zeiss Meditec. Dr. Packard has financial interests with Alcon. Contact information Alio: jlalio@vissum.com Bellucci: robbell@tin.it Kretz: mail@florian-kretz.de Packard: mail@eyequack.vossnet.co.uk because the extended depth of focus will help vision in these eyes." As with all premium lenses, patient communication and man- agement of vision expectations are the key to success. "Like all multifocals, trifocal IOLs will not be able to make your patients see at all distances like an emmetropic 20-year-old, but they are a good compromise for patients wishing for greater spectacle inde- pendence," Dr. Packard said. EW Editors' note: Dr. Alio has financial interests with AkkoLens (Breda, the Netherlands), Hanita Lenses (Israel), Oculentis, and Carl Zeiss Meditec. Dr. Bellucci has financial interests with the PhysIOL has a 4 C-loop haptic, Dr. Kretz explained. Rotational sta- bility of the platforms is "excellent," Dr. Kretz said, adding he corrects corneal astigmatism as soon as the calculation shows a postop astigma- tism of 0.75 D or more. Dr. Bellucci offered these pearls: "Look for emmetropia—there is no need for monovision with these lenses. Try to correct for any astig- matism in excess of 0.5 D, as I've found these IOLs are less sensitive to residual astigmatism than bifocals. Consider dry eye, as the more com- plex optics might increase patients' sensitivity to corneal surface prob- lems. And finally, consider trifocal IOLs after corneal refractive surgery Compared to the lenses avail- able in the U.S., Dr. Kretz said trifo- cal IOLs have 2 different diffractive patterns. The intermediate pattern has half the power of the distance pattern—so, for example, the AT Lisa tri has a near 3.33 D with an intermediate 1.66 D. "Straylight created at the inter- mediate pattern projects about 4% of its light energy to double the add power, meaning it is projected to the near pattern, enhancing the light efficiency there," he said. Addition- ally, this technology reduces the overall energy loss. Carl Zeiss Meditec and VSY Biotechnology have a plate design platform, and the toric version of The Zeiss trifocal lens Source: Carl Zeiss Meditec " Trifocal IOLs provide intermediate vision without compromising near vision, and intermediate is more important to patients as our world is now dominated by computers, smartphones, and tablets. " –Roberto Bellucci, MD

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