Moving on to IOLs, Dr. Cleary discussed her experience using the TECNIS® Toric II IOL, which is an adaptation of its predecessor, the TECNIS® Toric IOL. The haptics of the Toric II IOL have been frosted to increase the toric stability. “This is important to me as a surgeon in Australia where we use a lot of toric IOLs,” Dr. Cleary said. Dr. Cleary stated that she implants toric IOLs in her patients at the Royal Victorian Eye and Ear Hospital if keratometric astigmatism is 1.5 diopters or more. However, in her private practice, she has no restriction on the toric lens she uses. “I will choose the lens implant for my patient that gives the Copyright 2023 APACRS. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or publisher, and in no way imply endorsement by EyeWorld, Asia-Pacific or APACRS. All other trademarks are the intellectual property of their respective owners. © Johnson & Johnson Surgical Vision, Inc. 2023 PP2023MLT6431 cases, and is highly suitable for trainees to use. Dr. Cleary has also had the opportunity to use the VERITAS Swivel handpiece in a wetlab environment. She notes that the updated handpiece is shorter, lighter, and all-around less bulky. The distal portion of the handpiece also swivels, “so if you’re placing it into the eye, if you like to turn the tip over or maneuver it during phacoemulsification, you don’t have to move the entire handpiece around,” she said. Additionally, the tubing of the handpiece is angulated downwards which provides a much better ergonomic experience for the surgeon. “We’re learning more about thinking about our posture [during surgical procedures]. A longer and heavier handpiece will be sticking into your chest or abdomen. With the shorter handpiece and the tubing that drapes downwards, I’m really looking forward to seeing the ergonomic feel at the operating table,” Dr. Cleary said. lowest predicted post-operative astigmatism. I’m not looking at what the K value is, but I’m taking it into account,” she said. In 2023, 68% of the IOLs she implanted have been toric IOLs. “I want a lens that is stable in the eye.” A surgeon needs to consider various aspects when choosing a lens for a patient. How the IOL loads, implants, and aligns are important considerations along with intraoperative performance and refractive outcomes. Long term stability and biocompatibility are also important. In Dr. Cleary’s real world experience, she compared two patient groups implanted with either the TECNIS® Toric II IOL or the TECNIS® Toric IOL. Reviewing the results at day 1 and at 3 weeks after surgery, Dr. Cleary found that the TECNIS® Toric II IOL had a median rotation of 1 degree compared to the TECNIS® Toric IOL with a median rotation of 4 degrees with results being statistically significant. At week 3, the TECNIS® Toric II IOL had a median rotation of 0 degrees compared to the TECNIS® Toric IOL with a median rotation of 6 degrees. Finally, 94.5% of eyes implanted with the TECNIS® Toric II IOL had less than 5 degrees of rotation. All in all, Dr. Cleary found excellent intraoperative handling abilities of the TECNIS® Toric II IOL, a very low degree of postoperative rotation, and zero cases returning to the operating theater for IOL repositioning. References: 1. Dick HB, Ang RE, Corbett D, et al. Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens. J Cataract Refract Surg. 2022;48(11):1270-1276. “ With the shorter handpiece and the tubing that drapes downwards [with the VERITAS Swivel handpiece], I’m really looking forward to seeing the ergonomic feel at the operating table.” Georgia CLEARY, MBBS, PhD, FRCOphth Australia “ At day 1 and at 3 weeks after surgery, TECNIS Toric II IOL had a median rotation of 1 degree compared to the TECNIS Toric IOL with a median rotation of 4 degrees. At week 3, TECNIS Toric II had 0 degress median rotation.” Georgia CLEARY, MBBS, PhD, FRCOphth Australia
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