EyeWorld China December 2019 Issue

Clareon ® - a new standard for IOL clarity Larry Li Clareon ® features an advanced IOL design and provides unsurpassed clarity of a truly pristine premium IOL thus setting a new standard for IOL clarity. Clareon ® constitutes a precision edge design that minimizes glare and dysphotopsia. 6 The precision design of Clareon ® is a result of the new cryo-milling process, which incorporates a proprietary curvature on the side to minimize edge glare and posterior capsular opacification (PCO), explained Dr. Larry Li, Head of RMA, Alcon, Asia-Pacific. From a biomechanical perspective, Clareon ® incorporates STABLEFORCE ® haptics to maintain optical stability during compression and allows rapid and controlled unfolding of the IOL due to lower glass transition temperature and with the help of AutonoMe ® delivery system. 6 (Figure 1) A study that compared Clareon ® with single- piece AcrySof ® IOL, enVista ® , TECNIS ® , and Vivinex ® revealed that Clareon ® and AcrySof ® show significantly lower axial displacement than others. 7 Clareon ® also demonstrates minimal glare response compared to leading competitors and provides unsurpassed clarity with lowest level of surface haze, subsurface nanoglistenings (SSNGs), and glistenings than other premium monofocal IOLs. Figure 1: Clareon ® STABLEFORCE ® haptics maintain optical stability when compressed to 9 mm Clareon ® is a next generation advanced design monofocal IOL made from hydrophobic acrylic, which provides unsurpassed optical clarity of a truly pristine premium IOL offering lowest level of surface haze, subsurface nanoglistenings, and glistenings, compared to other premium monofocal IOLs. Clinical experience with Clareon ® Autonome ® Fook Meng Cheong Clareon ® Autonome ® is the first and only automated, disposable and preloaded IOL delivery system, driven by an innovative CO2-powered delivery mechanism. 8 It is easy and intuitive and allows single-handed injection with a responsive speed control lever and comfortable ergonomic hand positions. 9,10 It protects incisions with its proprietary depth guard and provides full IOL visibility during delivery with a 3 mm nozzle tip length. (Figure 2) The Clareon ® Autonome ® delivery system is prepared in three simple steps with well-defined end-points. The first step involves filling the chamber with ophthalmic viscosurgical devices (OVD) to the tip of the nozzle to ensure a fixed column of OVD in every case, the second step consists of removing the lock-out assembly and the third step involves pressing down fully on the lever to advance the IOL to its pre-delivery position. The automated IOL delivery is then initiated and controlled by the surgeon with the speed control lever. “With well-defined end-points in the preparatory stage and the automated advancement of the plunger, the volume of OVD and speed of plunger advancement are standardized in every case. Having the same volume of OVD and the same speed of plunger advancement contributes to consistent folded configurations of the IOLs”, explained Dr. Fook Meng Cheong. Dr. Cheong presented an observational audit of his initial experience with the Clareon ® Autonome ® delivery system comprising of pooled data from 3 sites involving 36 eyes of 33 patients and followed for 1 month. There was minimal corneal incision wound stretch for 2.2 mm incisions; no wound stretch for 2.4 mm incisions and nozzle tip integrity was maintained in all cases without post-operative injector tip damage. With regards to unaided distance visual acuities, all eyes could see 20/40 or better, and 64% of ideal eyes for non-toric IOLs (based on the Barrett Toric calculator) could see 20/20 and 100% could see 20/25 or better. In assessing refractive predictability at 1-month follow-up, 95.6% of eyes were within 0.50D of predicted refraction. In eyes that the Barrett Toric calculator recommended a non-toric IOL implant, 100% of eyes were within 0.50D of predicted refraction. "In my experience, the feedback received from surgeons was extremely satisfactory regarding the simplicity of preparation, ease of implantation, responsiveness and intuitiveness of using the Clareon ® Autonome ® delivery system," added Dr. Cheong. Clareon ® AutonoMe ® is an easy and intuitive automated preloaded IOL delivery system that allows single-handed IOL injection with responsive speed control lever and comfortable ergonomic hand positions. 3 Zhao Ping Shenyang AIER Eye Hospital China VilavunPuangsricharern Chulalongkorn University Hospital Thailand Abhijeet Desai Sohum Eye Care Centre India Krishna Prasad MM Joshi Eye Institute India Zhang Chun Xiamen Eye Center Xiamen University China Figure 2: Advantages of Clareon ® Autonome ® Delivery System Photographs courtesy of Dr Cheong