EyeWorld India December 2018 Issue

sis, Dr. Wu said. Postoperative residual astigmatism significantly degrades visual acuity at all contrast levels. Dr. Wu presented some of the theoretical effects of IOL rotation on astigmatism correction, noting that this is worse with higher cylin- der powers. Five degrees of rotation results in 16% undercorrection of astigmatism, 10 degrees of rotation results in 33% undercorrection of astigmatism, and 16 degrees of rota- tion results in 50% undercorrection of astigmatism. At a rotation greater than 30 degrees, this annuls the ben- efit of the toric lens, he said, adding that the greatest rotation occurs in the early postoperative period, with little rotation after 1 week. Dr. Wu described his own pro- spective, single-arm study in Australia using the Vivinex ™ Toric T2 IOL. The study included 20 consecutive patients with corneal astigmatism ranging from 0.75 to 1.5 D who underwent cataract surgery with the Vivinex T2 Toric IOL. The target cylinder was less than 0.5 D. Preopera- tive and 4-week postop measurements were taken. Dr. Wu also highlighted the use of the Vivinex ™ iSert ® preload- ed injectable for the Vivinex ™ Toric, which he said offers unidirectional slider advancement, a transparent cartridge, and a screw design where the injector length remains constant during IOL insertion. patients “satisfied” and the remaining 60% “very satisfied.” Prof. Bissen-Miyajima discussed the implantation of the Vivinex ™ IOL, using the Vivinex ™ iSert ® preloaded injector. The outer diameter of its precision tip is 1.7 mm and the inner diameter is 1.5 mm, and the Vivinex ™ IOL can be implanted through a 2 mm incision. She shared that the final inci- sion size was the smallest compared to other IOLs, which allows for stable postoperative refraction. Finally, Prof. Bissen-Miyajima touched on long-term stability with the Vivinex ™ material. Glistenings are reduced in eyes with Vivinex™, and there is a new approach to reduce PCO with Vivinex ™ . The IOL surface is modified to increase the adhesion to the posterior capsule. Prof. Bis- sen- Miyajima showed study data that demonstrated that the Vivinex ™ had a lower rate of PCO than the control group. Johnny Wu, MD , Perth, Austra- lia, presented “Practical Pearls for Op- timizing Outcomes using the HOYA Vivinex Toric IOLs.” Dr. Wu discussed published data on cataract surgery and astigmatism. He said that there is preoperative cor- neal astigmatism in 40% of cataract surgery patients, of which 60% are low range (0.75 to 1.0 D). Residual re- fractive astigmatism and dependence on spectacles still persist today but are reduced by toric IOLs in meta-analy- Copyright 2019 ASCRS Ophthalmic Corporation. 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, ASCRS, or APACRS. Rupert Menapace, MD Johnny Wu, MD Susana Marcos, PhD In the study, Dr. Wu said there were no surgery complications, no postop retinal tear/uveitis/macular edema, the distance spectacle inde- pendence was 100%, and there was a reduction in postoperative refrac- tive astigmatism to 0.53 D +/–0.36 D, and clear benefits when comparing pre- and postop spherical equiva- lent results. From the study, Dr. Wu concluded that the use of Vivinex ™ T2 IOL is a safe and reasonably predict- able choice, which provides effective correction of spherical and astigmatic errors. It can minimize mean postop astigmatism and spherical equivalent and optimize distance spectacle inde- pendence. Better visual and refractive results are reported to be associated with greater perception of visual qual- ity and greater quality of life, Dr. Wu said, adding that more multicenter prospective trials could be helpful. Susana Marcos, PhD , Madrid, Spain, wrapped up the session by pre- senting “New Dynamic Optical Bench Tests: Influence of IOL Aspheric Profile and Decentration on Image Quality.” She first discussed asphericity of the IOL surfaces and IOL decentration and how these two factors contribute to image quality. As lenses become more sophisticated, there is a concern that while correcting for spherical ab- erration of the cornea, aspheric IOLs would on the other hand increase coma. Dr. Marcos presented data from one of her studies, which showed that aspheric IOLs not only compensated for spherical aberration, but coma was lower in eyes implanted with aspheric than spherical IOLs. She also shared a study looking at the impact of decentration on dif- ferent state-of-the-art IOLs, includ- ing aspheric lenses from Alcon (Fort Worth, Texas) and Johnson & Johnson Vision (Santa Ana, California), and the Vivinex ™ IOL. The IOLs were mounted in an artificial eye model, with a realistic cornea and a microm- eter stage, which allowed introducing known amounts of decentration. In the study, it was found that for the same magnitude of decentration, the amount of induced astigmatism and coma was less for the Vivinex™ IOL than the other IOLs. Dr. Marcos said that these findings are significant for clinicians because decentration from the optical axis naturally occurs in every eye, and the specific design of Vivinex ™ IOL makes it more immune to decentration than other aspheric IOLs. Reduced aberrations and there- fore increased image quality is associ- ated with better visual quality. Dr. Marcos suggested that a simi- lar study could be done in the future on toric IOLs to look at decentration. Sponsored by HOYA Surgical Optics