EyeWorld Asia-Pacific September 2015 Issue

September 2015 27 EWAP FEATURE phacoemulsification,” he said. Postoperatively, investigators found that there was a statistically greater reduction in astigmatism in the group that received the toric lenses versus the controls, Dr. Pepose noted. With the lens, the mean residual astigmatism was less than 0.5 D in all of the groups, even for those with the highest preoperative astigmatism, he said. “Even the high preexisting corneal astigmatism was effectively reduced, and the TRULIGN had great rotational stability,” he said, adding that approximately 96% of patients had postoperative rotation of the lens of less than 5 degrees. Not all toric lenses could boast such stability, he said. “A lot of standard toric lenses do rotate postoperatively, and with every degree of rotation away from the optimum axis you’re losing about 3% [of toric effect]—so if the lens rotates 10 degrees, you’ve lost 30% of the effect of the toric lens,” Dr. Pepose said. Investigators found that with the TRULIGN lens patients enjoyed excellent distance vision, great intermediate and functional near, together with reduced astigmatism, Dr. Pepose reported, adding that this was true for those with both lower and higher magnitudes of preexisting astigmatism. “The toric component didn’t seem to produce any new safety concerns,” he said. “There wasn’t any increase in glare or any of those issues.” Still, to ensure the best results with the TRULIGN, attention to detail is needed. “You do have to polish the capsule,” Dr. Pepose said. “It requires a meticulous cortical cleanup.” Also, with this type of lens, creation of a nice, round rhexis is important, he stressed, adding that this is true with the Crystalens as well. In addition, if a practitioner sees any capsular striae, Dr. Pepose advised doing an early YAG, as left alone this could create a change in the position of the lens. Overall, Dr. Pepose pointed out that the TRULIGN offers an advantage with astigmatism improvement and some presbyopia correction. “I think for most patients when comparing it to a standard toric lens, you get something extra,” he said, adding that with the lens patients get uncorrected distance of about 20/25 and intermediate vision of about 20/22. While near acuity is in the 20/39 range offering about 1 D of through focus, that is just with correction in one eye, Dr. Pepose said. “In the second eye, you can create a little bit of monovision,” he said. “Even if you target –1 D, most people can tolerate a diopter of monovision and you’re getting good depth of field, so that works out well.” EWAP Reference Pepose J, et al. Safety and effectiveness of a new toric presbyopia-correcting posterior chamber silicone intraocular lens. J Cataract Refract Surg. 2015 Feb;41(2):295–305. Editors’ note: Dr. Pepose has financial interests with Bausch + Lomb. Contact information Pepose : jpepose@peposevision.com MORIA S.A. 15, rue Georges Besse 92160 Antony FRANCE Phone: +33 (0) 1 46 74 46 74 - Fax: +33 (0) 1 46 74 46 70 moria@moria-int.com - www.moria-surgical.com THE MORIA OPTION FOR SBK Make your own comparisons between the One Use- Plus and a femtosecond laser in terms of capital investment, disposables per patient, and annual maintenance. www.moria-surgical.com Think Thin Thin, 100-micron, planar flaps Accuracy and predictability equivalent to Femto-SBK Smoother stromal bed No femto-complications … At a fraction of the cost