EyeWorld India September 2021 Issue

FEATURE 10 EWAP SEPTEMBER 2021 by Chiles Aedam R. Samaniego E x perts sifted through the glut of innovative new IOL designs to sort the wheat from the chaff in an APACRS Symposium held at the 33rd APACRS– SNEC 30th Anniversary Virtual Meeting. Overview Chandra Bala, PhD, MBBS, FRANZCO, Australia, provided a “generic overview and homage to the great innovators,” presenting a diagram of the birth and growth of IOLs with the £9{9 work of Sir Harold Ridley at its base. The material of that first lens, PMMA, would be the dominant material over the next 3ä years until the next major design innovation in 1989 and 1990, when AMO and Alcon consecutively introduced the first foldable IOLs. In summary, Dr. Bala said that while significant changes have been made in both optic and haptic design, the This article was adapted from the EyeWorld Asia-Pacific daily coverage of the 33rd APACRS–SNEC 30th Anniversary Virtual Meeting, held online from 30 to 31 July 2021. current success is owed to the pioneering work of engineers, doctors, and patients. New approaches in EDOF Some of the more popular IOL designs today incorporate extended-depth-of-focus (EDOF) technology; Gerd Auffarth, MD, PhD, FEBO, Germany, discussed three groups that use three different approaches to EDOF: Monofocal+ IOLs, such as the Johnson & Johnson Vision (J&J) TECNIS Eyhance, the ausch ³ omb ( ³ ) uxSmart, the Physiol/BVI IsoPure, and the Santen Xact MonoEDoF; classical EDOF IOLs such as the new AcrySof IQ Vivity (Alcon); and trifocal and hybrid IOLs such as the J&J TECNIS Synergy and Physiol/BVI Trivium. The Monofocal+ IOLs employ different optical concepts but resulting in a dysphotopsia profile “remarkably like» monofocal IOLs; the newer classical EDOF IOL Vivity employs a non-diffractive concept based on wavefront- shaping technology; and finally the hybrid optical tech IOLs combine traditional EDOF multifocal or trifocal patterns with improved near performance, optimized low light vision, and reduced dysphotopsias. Small apertures One strategy for extending the depth of focus follows the same principle as the F-stop in SLR cameras—using optics with small aperture. In particular, Sathish Srinivasan, MD, Scotland, discussed the AcuFocus IC-8 IOL, a single- piece acrylic IOL design most remarkable for a central mask measuring 3.23 mm with a central 1.36-mm aperture simulating pupil. In a 6-month follow-up post-market study in 12 sites across 6 countries in Europe (Austria, Belgium, Germany, Italy, Norway, Spain) involving 108 subjects with contralateral implantation of IC-8 in one eye with a refractive target of –0.75 and an aspheric colorless monofocal in the fellow eye, subjects had excellent mean monocular UCVA at far (1.15 decimal), intermediate (0.91), near (0.69) and binocular UCVA at far (1.0), intermediate (0.8), and near (0.63) at 1, 3, and 6 months. IOL Innovations Preparing for the Future Ronald YEOH, Singapore Michael LAWLESS, Australia Robert K. MALONEY, USA Chandra BALA, Australia IOL Innovations.indd 1 31/08/2021 12:03 PM