EyeWorld India March 2017 Issue

51 EWAP DEVICES March 2017 by Michelle Dalton EyeWorld Contributing Writer Trifocals outperforming other premium lenses Still not available in the U.S., trifocals are becoming the preferred technology among European surgeons W hen multifocal lenses were first introduced, they were heralded as a means of providing both near and distance vision improvements for patients undergoing cataract surgery. These IOLs feature two main foci, but patients continually demanded better intermediate vision. In today’s world, one could argue intermediate vision is even more crucial than near for performing daily tasks such as using a computer, tablet, or smartphone. Trifocal IOLs combine two diffractive profiles to improve vision across all spectrums, and published reports indicate high levels of both spectacle freedom and patient satisfaction. The technology has yet to be introduced in the U.S., but those familiar with the lenses are embracing the technology and think it offers patients the best potential visual outcome. “With trifocal IOLs, distance visual acuity (VA) is at least as good as a multifocal, intermediate VA is significantly better, and reading vision is slightly worse than a multifocal’s reading vision,” said Arthur Cummings, MBChB , Wellington Eye Clinic, Dublin, Ireland. In Ireland, three trifocal lenses are approved and available: AT LISA (Carl Zeiss Meditec, Jena, Germany), FineVision (PhysIOL, Liege, Belgium), and PanOptix (Alcon, Fort Worth, Texas). For A. John Kanellopoulos, MD , LaserVision.gr Institute, Athens, Greece, and clinical professor of ophthalmology, New York University Medical College, New York, the primary driving force behind these lenses has been intermediate vision and quality of vision in lieu of contrast sensitivity in the refractive cataract patient. “In the U.S., there’s been a step back from multifocal lenses and working with extended depth of focus. In Europe, though, there’s a very large following with trifocal lenses,” he said. Three technologies have been predominant in Europe: the FineVision, the AT LISA, and the PanOptix lens. In Belgium, in addition to those three lenses, the Alsafit (Alsanza, Pfullingen, Germany) and Acriva Reviol trifocal (VSY Biotechnology, Amsterdam, Netherlands) are also available, said Erik Mertens, MD , Medipolis, Antwerp, Belgium. The FineVision and AT LISA are also available in toric versions, and the PanOptix is expected to have a toric version shortly. Additionally, the second order The AcrySof IQ PanOptix toric IOL Source: Alcon The FineVision trifocal lens Source: PhysIOL The AT LISA trifocal 839MP Source: Carl Zeiss Meditec continued on page 52