EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/87458
October 2012 EWINTERNATIONAL 93 near future. My results with diffrac- tive IOLs are superb and improving with time. For me, accommodative IOLs seem to lose effect over time, working as a monofocal after a while, which is the reason they preserve the contrast sensitivity when compared to multifocal IOLs. Dr. Ghanem: I am currently implant- ing multifocal IOLs in about 30% of my patients. It could be more than 50% if financial issues were not a problem. At our hospital, we have implanted accommodative IOLs in the past, but due to inconsistent re- sults, we are not implanting them anymore. Patients want the results they paid for. I hope this technology improves to provide better and more reproducible results. Dr. Trindade: I am not yet convinced that current accommodative IOLs, Our motivation. regardless of their mechanism of action, truly restore active accom- modation to a significant level, as they are touted to. It is important to point out that pseudoaccommoda- tion properties such as increased depth of focus in senile miosis, for instance, mild monovision, and myopic astigmatism are common situations, isolated or combined, that enhance near vision function, rendering many patients even with a standard monofocal IOL glasses-free. Another drawback of the current accommodative lenses is the larger incision length necessary for their implantation. In my mind, accom- modative IOLs are still an idealized concept but hopefully, in the not- too-distant future, the industry will provide us with a good product that will eventually replace multifocals. Dr. Nosé: We have had some experi- ence with so-called accommodative lens. Unfortunately, in our experi- ence, none of the three evolution models had enough accommodative power to allow true near vision, instead acting more as a monofocal lens. We have consequently focused on diffractive multifocal lenses with excellent results. At Santen, our single focus in ophthalmology enables research of novel therapies in uveitis, glaucoma, and dry eye/corneal disorders—therapies determined to challenge eye disease, one patient at a time. Inspiring ophthalmic medicines Dr. Casanova: After reviewing how the current technology works, I don't feel stimulated to implant ac- commodative IOLs. Possibly, in the near future, new designs and new concepts will offer better results. For now, I have used diffractive multifo- cal IOLs and monovision as options for presbyopic correction. The former are responsible for at least 50-60% of my practice. After combi- nation of multifocal and toric tech- nologies on the same platform, my percentage of patients receiving multifocals has increased. To learn how Santen is advancing the ophthalmic fi eld, scan this code with your mobile device or visit www.santeninc.com. Dr. Padilha: Do you feel premium IOLs are growing in Brazil? If your perception is that is not true, why do most of the Brazilian eye surgeons still prefer standard IOLs instead of premium IOLs? continued on page 94 Patients want the results they paid for. I hope this technology improves to provide better and more reproducible results Ramon Ghanem, M.D.