EyeWorld Asia-Pacific June 2019 Issue

42 EWAP JUNE 2019 CATARACT A patient with the Tecnis Symfony IOL. Source: Viral Juthani, MD F or presbyopic patients undergoing cataract surgery, a new option that may be attractive is the use of extended depth of focus (EDOF) lenses, according to Viral Juthani, MD , assistant professor of œ«…Ì…>“œœ}Þ] œ˜ÌiwœÀi Medical Center, Albert Einstein College of Medicine, New 9œÀŽ° ˜ÛiÃ̈}>̜Àà ̜œŽ > look at EDOF lenses that are available worldwide in a review published in Current Opinion in Ophthalmology. 1 Current backdrop Before EDOF lenses, the options for spectacle independence after cataract surgery were monovision with monofocal lenses or use of multifocal or accommodative lenses, Dr. Juthani explained. He said there are three main disadvantages with multifocal lenses. “First is the loss of contrast sensitivity, and the second is the limitations >ÃÜVˆ>Ìi` ܈̅…>ۈ˜} wÝi` vœV> points because they result in wÝi` ܜÀŽˆ˜} `ˆÃÌ>˜Við *>̈i˜Ìà would say they see well at a distance, intermediate, and near point, but in between, they had diminished visual quality.” Third, multifocal lens patients were reporting some photopsias such as halos, glare, and starbursts. The idea behind the lens was to improve the range of clear vision ܈̅œÕÌ wÝi` vœV> «œˆ˜Ìà ܅ˆi reducing photopsias and loss of contrast sensitivity. The Crystalens (Bausch + Close-up on extended depth of focus lenses by Maxine Lipner EyeWorld Senior Contributing Writer What these could mean for presbyopic patients œ“L] Àˆ`}iÜ>ÌiÀ] iÜ iÀÃiÞ® was the main accommodative i˜Ã° º ̅>à }ÀœÜ˜ œÕÌ œv v>ۜÀ as studies have shown that the effects of accommodation tend to wear off over time,” Dr. Juthani said. Emerging EDOF approaches The early stage review that investigators undertook ÃՓ“>Àˆâi` ̅i VÕÀÀi˜Ì " lenses available worldwide. Dr. Juthani said it is a big picture look at studies describing visual outcomes and patient satisfaction. Currently, there are three different types of EDOF lenses aimed at trying to provide more seamless near, intermediate, and distance vision. Only one, the Tecnis Symfony (Johnson & Johnson Vision, Santa Ana, California), is FDA approved. º ˜ÃÌi>` œv VÀi>̈˜} wÝi` focal points, they create a single elongated focal point to enhance the depth of focus for improved range of vision, and they focus incoming waves in an extended longitudinal «>˜i >à œ««œÃi` ̜ wÝi` «œˆ˜Ìà ÕȘ} “œ`ˆwi` `ˆvvÀ>V̈Ûi optics,” Dr. Juthani said. With the Symfony they tried to offset the limitations of having the elongated plane by correcting for chromatic aberration. There was little in the literature on this because the technology is so new but investigators did manage to w˜` œ˜i >À}i ÌÀˆ> 2 by the Concerto Study Group, which included 411 patients who underwent bilateral implantation of the Symfony lens. The study included two groups, one in which micro-monovision was the aim in the non-dominant Editors’ note: Dr. Juthani has PQ ƂPCPEKCN KPVGTGUVU TGNCVGF VQ JKU EQOOGPVU Contact information Juthani: 6 , 1/ J“œ˜ÌÀwœÀi°œÀ} 6JKU CTVKENG QTKIKPCNN[ CRRGCTGF KP VJG ,CPWCT[ KUUWG QH EyeWorld . It has DGGP UNKIJVN[ OQFKƂGF CPF CRRGCTU JGTG YKVJ RGTOKUUKQP HTQO VJG #5%45 1RJVJCNOKE 5GTXKEGU %QTR