EyeWorld Asia-Pacific December 2021 Issue

I n an APACRS webinar hosted on November 18, 2021, ve leaders in refractive cataract surgery came together for a discussion on the rapid development of new intraocular lens (IOL) designs that provide partial or full presbyopia correction. Re- fractive and cataract surgery has transformed greatly, and this lively interactive session reviewed some of the latest options in presbyopia correc- tion and optimizing results for our cataract patients. Redefining Spectacle Freedom with Presbyopia-Correct- ing IOL Technologies Han Bor Fam, MD, Singapore Visual needs for cataract surgery patients are wide and extensive and evolving to re- quire more reading needs and closer reading distances. Ideally, an IOL should allow patients to see distance well with continually good vision up to 33cm of near vision. With diffractive bifocal tech- nology, patients have very good distance vision and very good near vision, but there is a big gap in between, and “this is not very useful for the patient,” says Han Bor Fam, MD. In a comparison among different IOLs, Dr. Fam showed that the TECNIS Symfony ® extended depth of focus (EDOF) IOL provides high contrast, excellent dis- tance vision and functional near vision. The TECNIS Synergy™ IOL, on the other hand, combines diffractive multifocal technology with TECNIS Symfony ® to deliv- er continuous high-contrast vision across the functional range. The TECNIS Synergy™ IOL performs extremely well at distance vision, has indis- tinct ADD power, and bridges the visual gap of less than 0.1 logMAR, allowing patients with different requirements the freedom to see and work at their preferred personal dis- tances. Dr. Fam discussed a few stud- ies to show the effectiveness of TECNIS Synergy™. In one study, “Light Ef ciency Dis- tribution of Presbyopia-Cor- recting IOL,” Dr. Fam found that it is possible to determine usable light energy at distinct foci by observing the ratio of total light ef ciency over the clinically relevant defocus range. EDOF IOLs and hybrid presbyopia-correcting lenses were found to have higher light ef ciency than multifocal IOLs. Speci cally, TECNIS Synergy™ loses 0% of light compared to a monofocal lens, TECNIS Symfony ® loses 4%, and bifocals lose almost 20%. In a different prospective mul- ticenter study, Dr. Fam com- pared the TECNIS Synergy™ IOL to the PanOptix ® Trifocal IOL and found that TECNIS Synergy™ had higher visual acuities at every distance test- ed (far, intermediate, near [40 cm], and near [33 cm]) com- pared to the PanOptix ® IOL. In terms of illumination and con- trast, both TECNIS Synergy™ and PanOptix ® had similar mesopic best corrected dis- tance visual acuity (BCDVA), though TECNIS Synergy™ was superior in terms of distance visual acuity and photopic low-contrast BCDVA. Patients also reported seeing objects and reading street signs in the evening better with the Syner- gy™ IOL. In a published paper by Gabric et al (J Refract Surg 2021), Dr. Fam explained an impressive nding: this prospective case series showed that 100% of patients achieved uncorrected near visual acuity (40 cm) at 0.10 logMAR or better and 99% of patients achieving uncor- rected distance visual acuity at 0.10 logMAR or better with the TECNIS Synergy™ IOL. Additionally, patients report- ed high satisfaction with the TECNIS Synergy™ IOL. The TECNIS Synergy™ IOL, Dr. Fam concluded, is a smart choice for cataract patients requiring good visual acuity across a wide range of dis- tances. This IOL combines diffractive multifocal tech- nology with EDOF, delivers continuous high-contrast vision, and affords high levels of binocular visual acuity from far to near. The NewAge of Prebyopia Correcting IOLs “ TECNIS Synergy TM is a smart choice for cataract patients requiring good visual acuity across a wide range of distance. ” Dr. Dr. Han Bor Fam