s GLOBAL PRACTICE PATTERNS
ALL ABOUT IOLS | Preferred designs, premium IOL adoption rates, and the pipeline.
Premium Lens Technology Is an Important Part of JORGE L. ALIÓ, Any Refractive Cataract Practice MD, PHD, FEBOPHTH resbyopia-correcting IOLs this lens in clinical practice once it has are an important part of any the CE Mark—to clarify, I am particularly Alicante, Spain refractive cataract surgery interested in a group of lenses sometimes practice, including mine. In my referred to as monofocal plus. routine practice of lens surgery, I am impressed by the results Pwhich includes cataract surgery and achieved with the Tecnis Eyhance in my refractive lens exchange, I implant a independent clinical study. I am even presbyopia-correcting IOL in about more impressed by the superior near am also impressed with the CapsuLaser 70% of cases. vision outcomes reported with the (Excel-Lens), which I routinely use AcrySof IQ Vivity. I think that, in the in these cases to make a perfect CURRENT AND POTENTIAL future, these lenses will replace most of capsulotomy. This device is much more FUTURE PREFERENCES the monofocal lenses that I currently cost-effective than a femtosecond laser, I participate in many clinical implant. (Editor’s note: For more a technology I abandoned for cataract studies of various models and types on these and other new-technology surgery due to its poor cost-effectiveness. of multifocal and extended depth of monofocal IOLs, see the article on pg focus (EDOF) lenses,1 and I therefore 24). I see no reason not to use IOLs CONCLUSION have my own outcomes for most of that provide my patients with better I forsee a new category of monofocal the available premium IOLs. I do not intermediate vision without reducing IOLs: monofocal plus IOLs, which offer EDOF IOLs, with the exceptions contrast sensitivity, giving an inadequate actually is a new type of EDOF lens. (I of the Tecnis Eyhance (Johnson & quality of vision, or causing unwanted am currently developing a classification Johnson Vision) and AcrySof IQ Vivity dysphotopsias such as occurs with for monofocal+ lenses, as there is (Alcon) in my private practice because current EDOF IOLs.4,5 confusion surrounding this topic.) I have found that many so-called EDOF I also plan on integrating the Lumina IOLs provide poor near vision and PATIENT SELECTION into my armamentarium as soon as it an inadequate quality of vision. My Many patients, when properly becomes commercially available. If real multifocal IOL preferences outside of selected, do well with a multifocal IOL accommodation can be achieved by this clinical investigations are the diffractive that is chosen to meet their conditions IOL, the approach of multifocality will be AT LISA tri (Carl Zeiss Meditec) and needs. When I assess patients for abandoned in clinical practice. and the refractive Acunex Vario cataract surgery, I start by asking myself 1. Alió JL, Pikkel J. Multifocal Intraocular Lenses: The Art and the Practice. (Teleon Surgical) with a near vision add the following question: “Why should Springer; 2014. 2. Alió JL, Simonov A, Plaza-Puche AB, et al. Visual outcomes and accommodative of +1.50 D and a new IOL hydrophobic this patient not have a multifocal or response of the Lumina accommodative intraocular lens. Am J Ophthalmol. 2016;164:37-48. material. I also frequently use the EDOF lens?” My first choice is always 3. Alió JL, Simonov AN, Romero D, et al. Analysis of accommodative performance RayOne Trifocal (Rayner), FineVision to consider a multifocal IOL for of a new accommodative intraocular lens. J Refract Surg. 2018;34(2):78-83. 1 4. Alió JL. Presbyopic lenses: evidence, masquerade news, and fake news. Asia (PhysIOL), and Intensity (Hanita). every patient. Pac J Ophthalmol. 2019;8(4):273-274. In the near future, my preference I do not, however, implant 5. Kanclerz P, Toto F, Grzybowski A, Alió JL. Extended depth-of-field intraocular lenses: an update. Asia Pac J Ophthalmol. 2020;9(3):194-202. will become accommodating IOLs, as presbyopia-correcting lenses in patients the Lumina (Akkolens International), with maculopathy or poor macular implanted in the sulcus,2,3 will be the function, retinal dystrophy, optic JORGE L. ALIÓ, MD, PHD, FEBOPHTH first accommodating IOL to truly work atrophy, and moderate to advanced n Professor and Chairman of Ophthalmology, as designed. I was the investigator in glaucoma because the benefits of using a Vissum-Instituto Oftalmologico de Alicante, Spain the preliminary phase 1 and 2 studies multifocal lens do not outweigh its cost n Miguel Hernandez University, Alicante, Spain and am currently the clinical director for these patients. n Member, CRST Europe Editorial Advisory Board and one of the investigators in the When I implant multifocal and n [email protected] phase 3 multicenter study in Spain and other presbyopia-correcting IOL n Financial disclosure: Consultant (AkkoLens Colombia. Results to date have been designs, I use a capsular tension ring International, Hanita Lenses); Clinical impressive, and I look forward to using to guarantee centration and stability. I investigator (Ophtec)
38 CATARACT & REFRACTIVE SURGERY TODAY | JANUARY 2021 GLOBAL PRACTICE PATTERNS s
Patients Want a Lens That Will Decrease Their Spectacle Dependence
ver the 20 years I have been independence and a decreased need for practicing ophthalmology, a refractive enhancement. the expectations and needs of ASHRAF ARMIA patients have changed. Today, PREMIUM IOLS BALAMOUN, patients who undergo cataract I use multifocal and EDOF IOLs MD, MSC, FRCS Osurgery expect spectacle independence. (Figure 1) in approximately 20% of my In my experience, some IOLs accomplish patients. I always ask patients about their (GLASG), FACS this goal better than others. Herein, I work and recreational activities to get as share my preferred lens technologies complete a picture as possible of their Cairo, Egypt and discuss the technologies I am most predominant visual needs. For example, excited to try next. if manual labor or computer work is an More than 70% of my patients receive integral part of a patient’s lifestyle, good spectacle independence except for some form of astigmatism correction. I intermediate vision is a priority with a reading small print.1,2 Recently released typically use limbal relaxing incisions for multifocal IOL. If spectacle-free reading diffractive lenses may perform better eyes with less than 1.00 D of astigmatism, ability is strongly desired, a multifocal than refractive lenses in terms of near and I use either the AcrySof IQ Toric IOL with a corresponding near addition vision and quality of vision. Likewise, SN60T3 to SN60T9 IOLs (Alcon) or the may be the best choice. If both distances there seems to be less risk of halos with Tecnis Toric IOL (Johnson & Johnson are used equally, a trifocal IOL would be the latest premium IOL technologies Vision) for eyes with more than 1.00 D suitable. I always consider the defocus compared with older diffractive and of astigmatism. In eyes with regular curves of various IOLs when deciding refractive lenses. corneal astigmatism, a toric IOL provides which one to recommend. I find that the AcrySof IQ PanOptix better distance UCVA, greater spectacle I like to use EDOF IOLs with a (Alcon) and FineVision3 IOLs provide independence, and lower amounts of refractive segmental design such as the the best outcomes when the treatment residual astigmatism compared with a Tecnis Symfony (Johnson & Johnson plan takes into account preoperative nontoric IOL paired to limbal relaxing Vision), and I use a blended vision diagnostics such as corneal topography, incisions. Postoperative astigmatism of strategy by targeting emmetropia in OCT of the macula, dry eye evaluation, 0.50 D or less is associated with improved the dominant eye and -1.50 D in the and biometry measurements (Figure 2).4 visual function and increased patient nondominant eye. Patients with this satisfaction due to greater spectacle form of blended vision generally achieve s WATCH IT NOW Dr. Armia provides tips for intraoperative maneuvers A B C with premium trifocal IOLs and showcases some of the tools he uses.
Figure 1. The Tecnis Symfony (A), FineVision (B), and AcrySof IQ PanOptix (C) IOLs in situ.
Figures 1 and 2 courtesy of Ashraf Armia Balamoun, MD, MSc, FRCS (Glasg), FACS BIT.LY/01ARMIA0121
Figure 2. Measurements and IOL power calculation for an eye implanted with the AcrySof IQ PanOptix IOL. BIT.LY/02ARMIA0121
JANUARY 2021 | CATARACT & REFRACTIVE SURGERY TODAY 39 s GLOBAL PRACTICE PATTERNS ALL ABOUT IOLS
I also use the Tecnis Eyhance. With FineVision), and the Tecnis Synergy ASHRAF ARMIA BALAMOUN, MD, MSC, FRCS this IOL, I target the dominant eye (Johnson & Johnson Vision) to become (GLASG), FACS for distance and intermediate vision available in Egypt, where I practice. n Al Watany Eye Hospital, Cairo, Egypt and the nondominant eye for less n Watany Research and Development Center, 5 1. Nivean M, Nivean PD, Reddy JK, et al. Performance of a new-generation Cairo, Egypt intermediate and more near vision. extended depth of focus intraocular lens—a prospective comparative study. Asia Regardless of the chosen IOL and Pac J Ophthalmol. 2019;8:285-289.. n Ashraf Armia Eye Clinic, Giza, Egypt 2. Kessel L, Andresen J, Tendal B, et al. Toric intraocular lenses in the correction n Armia’s Ophthalmology Training Observer-Ship strategy, I always compare two IOL of astigmatism during cataract surgery: a systematic review and meta-analysis. power calculation formulas to ensure Ophthalmology. 2016;123:275-286. Academy, Giza, Egypt 3. Sigireddi RR, Weikert MP. How much astigmatism to treat in cataract surgery. n Founder, Global Education and Research Society the best outcomes. Curr Opin Ophthalmol. 2020;31:10-14. 4. Cochener B, Boutillier G, Lamard M, Auberger-Zagnoli C. A comparative evalu- of Ophthalmology ation of a new generation of diffractive trifocal and extended depth of focus n [email protected]; FUTURE OUTLOOK intraocular lenses. J Refract Surg. 2018;34(8):507-514. I am waiting for the Vivity, the IsoPure 5. Breyer DRH, Kaymak H, Ax T, Kretz FTA, Auffarth GU, Hagen PR. Multifocal www.ashrafarmiaeyeclinic.com intraocular lenses and extended depth of focus intraocular lenses. Asia-Pac J n Financial disclosure: None acknowledged and Triumf EDOF IOLs (both from Ophthalmol. 2017;6:339-349.
Determine the Value of the IOL for Each Patient
lmost all patients can • IOLs with a diffractive, modified optic. take advantage of At present, an IOL that provides FRANCESCO presbyopia-correcting full range-of-distance spectacle CARONES, MD IOLs. It is just a matter of independence and has the dysphotopsia understanding what the best profile of a standard aspheric monofocal Milan, Atechnology is for each of them. does not exist. Italy CATEGORIES MY PRACTICE The broad availability of IOLs that I am partial to the use of perform differently allows surgeons to presbyopia-correcting IOLs. Herein I customize visual results to each patient’s describe why. needs at the time of cataract surgery Mindset. In my practice, lens or refractive lens exchange. The main replacement is always considered to be a parameters to consider when counseling purely refractive procedure regardless of patients are spectacle independence and whether a cataract is present. More than dysphotopsias. 50% of lens replacement procedures are When considering the former, there performed solely for refractive purposes. are at least four IOL categories, listed For this reason, presbyopia-correcting patient’s willingness to compromise here in order of increasing performance: IOLs are my standard type of lens (ie, having a full range of spectacle • Standard monofocal; implant, and all eyes for which greater independence with some degree • EDOF monofocal; than 0.50 D of residual astigmatism is of dysphotopsia in dim lighting or • Partial range-of-distance; anticipated receive a toric version of the enjoying partial range-of-distance • Presbyopia-correcting IOLs (EDOF selected lens. Approximately 80% to 85% spectacle independence with almost technologies); and of the lens procedures performed at my uncompromised night vision). • Full range-of-distance presbyopia- practice involve a presbyopia-correcting Of the presbyopia-correcting correcting IOLs (trifocal and hybrid IOL, and 50% of all procedures involve a IOLs I implant, 50% are full range-of- technologies). toric lens of some kind. Approximately distance diffractive lenses (trifocals Regarding dysphtopsias, IOLs can be 10% of eyes receive an EDOF monofocal and hybrid technologies), usually grouped into three categories, listed in lens, and less than 5% of eyes receive a the AcrySof IQ PanOptix and Tecnis order of increasing likelihood of inducing standard, nontoric monofocal IOL. Synergy. In my hands, the PanOptix visual disturbances: IOL selection. Our counseling process provides a better balance between • IOLs with a standard aspheric or focuses on determining the value spectacle independence and dyspho- spheric optic; of the procedure for each patient. topsia, with slightly weaker performance • IOLs with a nondiffractive, modified The value represents the difference for reading in dim light. I find that the optic; and between the benefits delivered and the Synergy provides a superior quality of
40 CATARACT & REFRACTIVE SURGERY TODAY | JANUARY 2021 GLOBAL PRACTICE PATTERNS s ALL ABOUT IOLS
vision under bright light and better are suitable choices when either a performance and meet the expectations intermediate to near performance in dim presbyopia-correcting IOL is not I set for patients. light but at the cost of more significant indicated or the patient is not interested Will a true accommodating IOL dysphotopsia in dim light. in spectacle independence. Both IOLs capable of providing full range-of-distance The remaining 50% of my provide some degree of useful range of spectacle independence without presbyopia-correcting IOLs are partial vision, but neither is currently available compromising quality of vision be a range-of-distance (EDOF) nondiffractive in a toric version. reality in the future? Only time will tell. lenses—almost exclusively the AcrySof IQ Vivity. This IOL provides most of my THE PIPELINE patients with spectacle independence I don’t expect revolutionary or FRANCESCO CARONES, MD (especially using a binocular game-changing IOL technologies to n Medical Director and Physician CEO, Carones mini-monovision strategy) with almost be released in the near term because Vision @ ADVALIA, Milan, Italy no nighttime dysphotopsias. most of the presbyopia-correcting IOLs n Member, CRST Europe Editorial Advisory Board The EDOF monofocal IOLs I soon to become available will likely fall n [email protected] implant routinely are the IsoPure into the categories described earlier. n Financial disclosure: Consultant (Alcon, Johnson and the Tecnis Eyhance. These lenses Currently available lenses deliver solid & Johnson Vision)
High Hopes for Two IOL Technologies in Development
currently use both monofocal and that includes total corneal power to presbyopia-correcting IOLs, and in the target 0.00 to -0.25 D of postoperative ARTURO future I hope to incorporate the use with-the-rule astigmatism. With this CHAYET, MD of two novel lens technologies that cost-related strategy, 60% of the IOLs I are still in development. implant are toric models. changing Tijuana, Mexico IAdoption rates. In my practice, the Preferred IOLs. I currently offer curvature adoption rates of monofocal and patients the AcrySof IQ monofocal IOL (Figure 3). presbyopia-correcting IOLs are 60% (Alcon), AcrySof IOL (model MA60, The second and 40%, respectively. I do not consider Alcon), enVista IOL (model MX60, exciting pipeline technology toric IOLs to be premium IOLs. If I Bausch + Lomb), AcrySof IQ PanOptix is another accommodating IOL, the categorized them as premium lenses, trifocal IOL, and Light Adjustable Lens Opira AIOL (ForSight Vision6). This then the adoption rates for premium (RxSight). Patient interest in the Light lens has a novel shape-changing and standard IOLs would be 72% and Adjustable Lens has become significant mechanism of ciliary body–driven 28%, respectively. in my practice, so it is currently a accommodation and capsular bag The cost of IOL surgery is the same key offering in my premium IOL fixation (Figure 4). The clinical whether a patient receives a toric armamentarium. trial results have been impressive. or nontoric IOL, whereas the price In more than 30 patients, mean structures for presbyopia-correcting THE PIPELINE and monofocal IOLs differ. I use The first of two IOL technologies swept-source OCT technology and the in development that are of greatest ray-tracing software Oculix (Panopsis) interest to me is the Juvene IOL (LensGen). It has two components, a capsule-filling base that is implanted in the capsular bag and a fluid-optic lens. By fully filling the bag, the base provides a stable bag-IOL component, and in my experience this decreases the incidence of posterior capsular opacification. The
Figures 3 and 4 courtesy of Arturo Chayet, MD fluid-optic lens is available in both a Figure 3. Depiction of the LensGen Juvene capsule-filling toric and a nontoric design. It provides IOL in situ. distance and near visual acuity by Figure 4. Design of the accommodating Opira AIOL.
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monocular corrected distance 2 years, and safety has been excellent. and intermediate visual acuities Thus far in my experience, patients ARTURO CHAYET, MD was 20/20, and distance-corrected have enjoyed excellent functional n Codet Vision Institute, Tijuana, Mexico near visual acuity was 20/25. These vision at all distances without n [email protected] results have been maintained for correction. n Financial disclosure: Consultant (ForSight Vision6, LensGen, RxSight)
Monofocal IOLs Still Leading
n my practice in Rio de Janeiro, is not yet available on a toric platform, its BRUNO M. Brazil, the majority of patients elect indications are limited. an aspheric monofocal IOL. This is I do not use EDOF IOLs for FONTES, MD, PHD largely because of the out-of-pocket many patients, but most of those costs associated with premium lens who have received this lens type are Rio de Janeiro, Itechnologies. About 75% of patients happy with their vision postoperatively. Brazil with more than 1.00 D of astigmatism Lastly, I am excited about the opt for a toric IOL, and the remaining upcoming availability of the 25% choose a standard monofocal IOL AcrySof IQ Vivity and Tecnis because of financial reasons. When I Eyhance IOLs in my country. 7. Zuberbuhler B, Signer T, Gale R, Haefliger E. Rotational stability of the AcrySof am implanting a standard aspheric 1. Lee BS, Chang DF. Comparison of the rotational stability of two toric intraocular SA60TT toric intraocular lenses: a cohort study. BMC Ophthalmol. 2008;8:8. monofocal, my preferred brands are lenses in 1273 consecutive eyes. Ophthalmology. 2018;125(9):1325-1331. 8. Wirtitsch MG, Findl O, Menapace R, Kriechbaum, et al. Effect of haptic design on change 2. Gyöngyössy B, Jirak P, Schönherr U. Long-term rotational stability and visual in axial lens position after cataract surgery. J Cataract Refract Surg. 2004;30(1):45-51. Alcon, Johnson & Johnson Vision, and outcomes of a single-piece hydrophilic acrylic toric IOL: a 1.5-year follow-up. Int J Ophthalmol. 2017;10(4):573-578. Hoya because of their lenses’ known 3. Potvin R, Kramer BA, Hardten DR, Berdahl JP. Toric intraocular lens stability in the capsular bag.1-8 orientation and residual refractive astigmatism: an analysis. Clin Ophthalmol. BRUNO M. FONTES, MD, PHD 2016;10:1829‐1836. Only about 10% to 15% of patients 4. Chua WH, Yuen LH, Chua J, Teh G, Hill WE. Matched comparison of rotational n OPTY Group, Rio de Janeiro, Brazil stability of 1-piece acrylic and plate-haptic silicone toric intraocular lenses in Asian n President, Brazilian Association of Cataract and who undergo routine cataract surgery at eyes. J Cataract Refract Surg. 2012;38(4):620-624. my clinic elect a presbyopia-correcting 5. Holland E, Lane S, Horn JD, Ernest P, Arleo R, Miller KM. The AcrySof Toric Refractive Surgery intraocular lens in subjects with cataracts and corneal astigmatism: a randomized, IOL. These patients most often receive subject-masked, parallel-group, 1-year study. Ophthalmology. 2010;117(11):2104-2111. n [email protected] 6. Kim MH, Chung TY, Chung ES. Long-term efficacy and rotational stability of Ac- n Financial disclosure: Lecture fees (Alcon, Johnson an AcrySof IQ PanOptix. The Tecnis rySof toric intraocular lens implantation in cataract surgery. Korean J Ophthalmol. Synergy is a close second, but because it 2010;24(4):207-212. & Johnson Vision, OFTA Vision Health/NC Farma)
New IOLs Enhance Premium Lens Adoption and JOHN A. HOVANESIAN, MD Patient Satisfaction Laguna Hills, California he current global pandemic has variety of needs and health conditions. caused dramatic shifts in how Furthermore, recent software advances people spend their time, and have helped practices with candidate many eye care practitioners selection and patient education. Use Plus, and the availability of other select have observed that consumers of this software helped to increase the IOLs have expanded the indications for Tare more aware than ever of premium premium IOL adoption rate at my premium IOLs. IOL technologies. In addition to the practice significantly, and I have heard Vivity. With a wide, flat defocus curve, premium lens options that have been from others that it has increased their Vivity provides consistent distance and available for years, many recently comfort with premium IOLs. intermediate vision when targeted for FDA-approved IOLs and others in plano and creates no more glare or other development can provide patients with EXPANDING INDICATIONS unwanted side effects than a monofocal greater spectacle independence and In the United States, the FDA’s lens, making it safe for any eye, in my reduced dysphotopsia. These lenses approval of two premium IOLs, the experience. Its defocus curve creates can also be used in patients with a wide AcrySof IQ Vivity and Tecnis Symfony a soft landing spot and forgives some
42 CATARACT & REFRACTIVE SURGERY TODAY | JANUARY 2021 GLOBAL PRACTICE PATTERNS s ALL ABOUT IOLS Courtesy of John A. Hovanesian, MD IC-8. Among lenses that are not yet FDA-approved, the IC-8 small-aperture IOL (AcuFocus) has performed impressively with regard to astigmatism correction in the FDA trial. Internationally, the lens is widely used for patients who have irregular astigmatism and other corneal aberrations. The IC-8 will almost certainly occupy an important place in the US market once it is approved. Juvene. Another highly anticipated lens is the Juvene IOL, a truly accommodating lens with optics that can be changed out as new technology becomes available. MDbackline. This web-based software platform educates incoming cataract patients on refractive options and administers a questionnaire that generates a visual profile report (Figure 5) to provide clinicians with a look at the patient’s likelihood of choosing an upgrade. It also details which upgrade options would best suit the patient. Based on complex algorithms, the software’s predictive value has been proven in a number of practices, which have seen Figure 5. Sample MDbackline visual profile report showing a patient’s visual history and two- to threefold increases in premium technology adoption. likelihood of upgrading to a premium IOL. CONCLUSION residual refractive error. When used with a mini-monovision New technologies are making it easier for surgeons to strategy, the Vivity lens can provide a full range of vision. serve patients better with a greater range of vision and fewer Symfony Plus. This IOL provides greater near vision and IOL-related side effects. Future approvals will extend indications reduces glare and halos compared with its predecessor. It may to include more irregular eyes and patients seeking true also serve a wider range of patients than previous generations accommodation. Lastly, innovative software is available to assist of EDOF IOLs. practices in identifying the best candidates for premium IOLs enVista. Many clinicians have found that patients and to help patients understand and accept these options. obtain a wide range of vision with the monofocal enVista and enVista Toric lenses. The nontoric enVista is not labelled as a premium lens; however, it is a valuable monofocal that, in my JOHN A. HOVANESIAN, MD opinion, deserves a place in every surgeon’s OR. n Private practice, Harvard Eye Associates, Laguna Hills, California n Clinical Instructor, Jules Stein Eye Institute, University of California, Los Angeles LOOKING AHEAD n Member, CRST Editorial Advisory Board I look forward to the availability of two lenses specifically in the n [email protected]; Twitter @DrHovanesian United States, and I am excited to see how much my premium n Financial disclosure: Consultant (AcuFocus, Alcon, Bausch + Lomb, Johnson & conversion rates increase with use of a recent software advance. Johnson Vision); Founder (MDbackline) Premium IOLs Make Up Only a Small Percentage of Lenses Implanted TETSURO OSHIKA, MD, y preferred IOLs are currently can be implanted through a 2.2- to PHD the Vivinex iSert (model XY1, 2.4-mm incision. Hoya Surgical Optics) and the The Lentis Comfort is a segmented, Tsukuba, Japan Lentis Comfort (model LS-313 rotationally asymmetric, EDOF IOL MF15, Teleon Surgical). with a +1.50 D near add. This IOL is MThe Vivinex is a monofocal IOL, categorized in the monofocal segment and I find its preloaded delivery because its cost is completely covered At our center, premium IOLs account system to be extremely well-made, by public insurance in Japan and the for approximately 10% to 20% of the highly reliable, and user-friendly. The incidence of photic phenomena is lenses we implant. A majority of these IOL itself is of high quality, and it very low.
JANUARY 2021 | CATARACT & REFRACTIVE SURGERY TODAY 43 n [email protected] are the AcrySof IQ PanOptix IOL and the Tecnis Synergy IOL. n Financial disclosure: Consultant (Alcon, Johnson & Johnson Vision, Mitsubishi Tanabe, Santen, Topcon); Lecture honoraria (Alcon, Glaukos Japan, Hoya, Japan Focus, Johnson & Johnson Vision, Kowa, Otsuka, Santen, Senju, Tecnopia, TETSURO OSHIKA, MD, PHD Tomey); Research funding (Alcon, Hoya, Johnson & Johnson Vision, Kowa, n Chairman and Professor of Ophthalmology, University of Tsukuba, Tsukuba, Japan Novartis, Otsuka, Pfizer, Santen, Senju, Tomey, Topcon)
Patient Satisfaction High With Premium Lenses
remium IOL options continue unsure of their goals for distance vision WILLIAM F. WILEY, MD to improve. As a result, or their monovision targets. Trifocality. indications for the use of The FDA approval of the Cleveland, Ohio these lenses are expanding, AcrySof IQ PanOptix IOL has helped us helping many of us increase become more confident with counseling Pvalue to our patients. Currently, our patients on premium lens technology conversion rate to premium IOLs is because our patients’ satisfaction is high around 35%. with this lens. We feel confident that platforms. We have seen patient patients will experience a full range of adoption of EDOF lenses increase as the THREE AREAS OF IMPROVEMENT vision with minimal side effects. technology improves. n Ultimately, the uptick in the EDOF. The newest premium IOL use of premium IOLs within my category that is gaining popularity practice is due to three main areas of within our practice is EDOF. In our WILLIAM F. WILEY, MD improvement in lens design. experience with this type of lens design, n Private practice, Cleveland Eye Clinic and Adjustability. We prefer the Light distance vision is not compromised, ClearChoice Custom LASIK Center, Cleveland, Ohio Adjustable Lens for challenging eyes and the additional intermediate vision n CRST Chief Medical Editor (ie, those with a history of refractive provides patients with more function n [email protected] surgery) and for patients who are compared to traditional monofocal n Financial disclosure: Consultant (Alcon, RxSight)
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