The AcrySof IQ PanOptix® diffractive trifocal IOL is well-known to provide excellent vision performances10,11. However, PanOptix® needs normally healthy eyes, except for cataract, and accurate biometrics to ensure a highly optimised outcome, according to Prof. Soon-Phaik Chee. All toricity should be corrected, since residual refractive error is a major cause of dissatisfaction in patients implanted with PanOptix® 12, along with halos and glare13. Vivity® instead does not split the light, providing a continuous range of vision from distance to intermediate and functional near9, with visual disturbances comparable to a monofocal14. Prof. Chee pointed out that Vivity® and PanOptix® can be seen as complementary, both providing excellent distance and intermediate vision, with PanOptix® winning on near acuity and Vivity® on the low rates of visual disturbances. She presented the case of a retiree with bilateral mild nonproliferative diabetic retinopathy (NPDR), irregular astigmatism resulting from previous pterygium surgery, epiretinal membrane in the right eye and mild normal-tension glaucoma in the left eye. Bilateral implantation of Vivity® gave her 20/25 bilaterally, N8 at 60 cm and N5 at 40 cm in the right eye, and N5 at 60 and 40 cm in the left eye. As a non-reader, the patient was spectacle-independent and very happy. Though multifocal technology has greatly improved in recent years, not all patients are good candidates for this type of IOLs. On the other hand, less than 30% of patients tolerate monovision, due to loss of stereopsis and failure to ignore blurry images from one half of the binocular field. Prof. Smita Agarwal had for long been looking for a lens capable of providing better predictable and consistent results, and AcrySof IQ Vivity® was the answer. Vivity® has become the standard of choice in her clinical practice, filling a gap for patients who do not want a monofocal but are not eligible for a trifocal lens. In her case series of 51 eyes at 6 weeks post-op, most patients achieved UDVA of 20/25 and intermediate vision of N4. Near vision was around N8 or N10, but only 8% of patients needed reading glasses for very close up activities. She found Vivity® to be a helpful and forgiving lens that allows for easy management and saves time as compared with other premium IOLs, a significant advantage for a busy clinical practice. Even a very low grade epiretinal membrane (ERM) may negatively affect the visual performances of a multifocal lens. AcrySof IQ Vivity®, however, can be an option in these cases, according to Dr. Sohee Jeon. She reported the case of a 70-year old male, with low-grade ERM which did not distort the outer retinal structure in his right eye, and low corneal astigmatism in the left eye. Jeon implanted Vivity® bilaterally to achieve some degree of spectacle independence and avoid severe dysphotopsia. Refractive and visual outcomes were positive and OPD-scan results suggested that Vivity® was well tolerated (Fig.3). In her second case the ERM had started to distort the outer retinal structure in the left eye. After removing the ERM, Jeon implanted Vivity® in both eyes. At 3 months, refractive and visual outcomes were very good. The patient said that she would choose Vivity® again, and even recommended it to family and friends. Prof. Smita Agarwal, Wollongong Eye Specialists, NSW, Australia Prof Soon-Phaik Chee, Singapore National Eye Centre “Happiness is the key to success. Behind any successful ophthalmologist, besides good surgery, a reliable predictable lens (AcrySof IQ Vivity®) ensures the Wow factor! “In my practice AcrySof IQ Vivity® has become a really superior alternative to a monofocal IOL, ensuring both patient and surgeon satisfaction” • AcrySof IQ PanOptix® and AcrySof IQ Vivity® can be seen as complementary • AcrySof IQ Vivity® is comparable to a monofocal in terms of visual disturbances • AcrySof IQ Vivity® provides predictable and consistent results • A time-saving option, and a significant advantage for busy practices • Suitable for patients with suboptimal vitreoretinal status AcrySof IQ Vivity® or AcrySof IQ PanOptix®? Good, predictable, consistent, meeting patients’ needs AcrySof IQ Vivity® in patients with epiretinal membrane Key highlights from surgeons’ clinical sharing in the User Meeting: Fig.3 - OPD scans show a similar PSF in the right and left eye Dr. Sohee Jeon, Keye Eye Center, South Korea “AcrySof IQ Vivity® is suitable for patients with suboptimal vitreoretinal status with no glare or starbursts and only negligible halos”
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