In a variety of studies, Prof. Choi examined outcomes of visual acuity, uncorrected defocus curve, contrast sensitivity, digital reading speed test, questionnaires for subjective satisfaction, photic phenomena, and the visual functioning questionnaire (VFQ-25) for different IOLs including mix & match scenarios. Prof. Choi found positive outcomes in binocular vision for mix & match with TECNIS Symfony™ and +3.25, the PanOptix® IOL, another mix & match (ZEISS AT LARA and AT LISA tri IOLs), and the Synergy™ IOL, though the Synergy™ IOL showed superior outcomes to the other three scenarios. Additionally, the Synergy™ IOL showed higher uncorrected defocus curves and faster reading speeds than the other IOL scenarios. Furthermore, mixing & matching the Synergy™ with Symfony™ or Eyhance™ provided promising uncorrected defocus curves. In summary, Prof. Choi emphasized the importance of comparing MTF curves of different IOLs (new IOLs may provide wider and higher energies in intermediate and near vision), the significance of surface roughness and optical scattering (regular surface patterns may better reduce surface scattering), and the advantage of full transmission of healthy blue light (provides better contrast especially during night time). Finally, Prof. Choi said, “for a continuous range of vision with better near visual acuity, we need to individualize and optimize using a ‘combined’ implantation strategy.” Redefining Near Vision Needs with PresbyopiaCorrecting IOL Han Bor Fam, MBBS, MMed, FAMS, Singapore For Han Bor Fam, MBBS, MMed, FAMS, viewing distance is a significant factor for patients undergoing IOL implantation. In particular, cell phone viewing distances may range from 32 cm to 40 cm on average for hardcopy text, text messages, and text on the internet for American patients. However, because Chinese characters contain many strokes, viewing distance is estimated to be 33.95 cm. “What we really need [for our Asian patients] is a 33 cm to 36 cm viewing distance,” said Dr. Fam. “So, how do we allow these people to see better with IOLs?” The answer lies within a new IOL with certain limits. Ideally, this IOL would not have much loss in visual acuity across the defocus range. At minimum, Dr. Fam stated that the range should not be more than 0.2 logMAR between the best distance vision and near vision. Observing the TECNIS Multifocal® IOL, one can see, with diffractive multifocal technology, that this IOL provides good far and near distance vision but not good intermediate distance vision. With the Symfony™ IOL, an EDOF IOL, there is good far distance vision, but visual acuity tapers off rapidly at 1.5 diopters. With the Synergy™ IOL, though, the combination of diffractive multifocal technology with EDOF technology delivers continuous high-contrast vision across the functional range. The result for patients is peak Supported by an educational grant from Johnson & Johnson Vision MTF curves of three different trifocal IOLs. The TECNIS Synergy™ IOL covers a wide reading distance from 33 cm to 27 cm. Optimizing Patient Outcomes with Supplement to EyeWorld Asia-Pacific September 2022 In a variety of studies, Prof. Choi examined outcomes of visual acuity, uncorrect d defocus curve, contrast sensitivity, digital readi g speed test, questionnaires for subj ctive sati faction, photic phenomena, and the visual functioning questionnaire (VFQ-25) for diff rent IOLs including mix & match scenarios. Prof. Choi found positive outcomes in binocular vi ion for mix & match with TECNIS Sy fony™ and +3.25, the PanOptix® IOL, another mix & match (ZEISS AT LARA and AT LISA tri IOLs), and the Synergy™ IOL, though the Synergy™ IOL showed superior outcomes to the other three scenarios. Additionally, the Synergy™ IOL showed higher uncorrected defocus curves a d faster reading speeds than the other IOL scenarios. Furthermore, mixing & matching the Synergy™ with Symfony™ or Eyhance™ provided promising uncorr cted defocus curves. In summary, Prof. Choi emphasized the importance of comparing MTF cu ves of different IOLs (new IOLs may provide wider and higher energies in intermediate and near vision), the signific nce of surface r ughness and optical scattering (r gul r surfa e patterns may b tter ed ce surf c scattering), and the advantage of full transmission of healthy blue light (provides better contrast especially during night time). Finally, Prof. Choi said, “for a continuous range of vision with better near visual acuity, we need to individualize and optimize using a ‘combined’ implantation strategy.” Redefining Near Vision Needs with PresbyopiaCorrecting IOL Han Bor Fam, MBBS, MMed, FAMS, Singapore For Han Bor Fam, MBBS, MMed, FAMS, viewing distance is a significant factor for patient u dergoing IOL im l nation. In particular, cell phone viewing distances may range from 32 cm to 40 c on average for hardcopy text, text messages, and text on the internet for American patients. However, because Chinese characters contain many strokes, viewing distance is estimated to be 33.95 cm. “What we really need [for our Asian patients] is a 33 cm to 36 cm viewing distance,” said Dr. Fam. “So, how do we allow these people to see better with IOLs?” The answer lies within a new IOL with certain limits. Ideally, this IOL would not have much los in visual acui y across t e defocus range. At minimum, Dr. Fam stated that the range should not be more than 0.2 logMAR between the best distance vision and near vision. Observing the TECNIS Multifocal® IOL, one can see, with diffractive multifocal t chnology, that this IOL provides go d far and near distance vi ion but not good intermediate distance vision. With the Symfony™ IOL, an EDOF IOL, there is good far distance vision, but visual acuity tapers off rapidly at 1.5 diopters. With the Synergy™ IOL, though, the combination of diffractive multifocal techn logy with EDOF technology delivers continuous high-contrast vision across the functional r nge. The result for patients is p ak Supported by an educational grant from Johnson & Johnson Vision MTF curves of three different trifocal IOLs. The TECNIS Synergy™ IOL covers a wide reading distance from 33 cm to 27 cm. Optimizing Patient Outcomes with Supplement to EyeWorld Asia-Pacific September 2022 Optimizing Patient Outcomes i IIn a lunch symposium hosted on Sunday June 12, 2022, three leaders in cataract surgery presented on new resear h findings and ways to optimize patient outcomes in the world of IOLs. With Professor Chul Young Ch i, South Korea, and Professor Oliver Findl, Austria, as moderators, audience members were first asked to consider their confidence in managing their patients’ visual expectations. The survey qu stions were asked again after the three presentations, and there was a trend in improved confidence in the audience’s own abilities to customize treatment for patients and meet their visual expectations in cataract and refractive surgery. Maximizing Surgical Success with Phaco and Toric IOLs Using Latest Innovations Professor Tetsuro Oshika, Japan Astigmatism is an increasingly important consideration in refractive surgery. From an ESCRS 2019 survey, the percentage of cataract procedures that involve a toric intraocular lens (IOL) for patients with clinically significant astigmatism is increasing year by year. To begi his presentation, Prof. T tsu o Oshika, Japan descri d the three p tt rns of astigmatism: with-the-rule (WTR), agai st-the-rule (ATR), and oblique astigmatism. In WTR astigmatism, the vertical meridian is the steepest and stays close to 90 degrees. In ATR astigmatism, the horizontal meridian stays close to 180 degrees, which is steeper than the vertical meridian. Finally, oblique astigmatism occurs if the principal meridians are neither at 90 degrees nor 180 degrees. The impact of these types of astigmatism on visual function is different as there are age-related changes that come with corneal astigmatism. As patients get older, WTR astigmatism takes over ATR astigmatism in the anterior chamber due to a thicker vertical cornea in older patients. Prof. Oshika further explained the role of K value in astigmatism. K value actually does not equal total corneal astigmatism. In fact, the K value overestimates WTR astigmatism while the toric IOL overcorrects WTR astigmatism. On the other hand, K values also underestimate ATR astigmatism while the toric IOL undercorrects ATR astigmatism. Furthermore, Prof. Oshika performed an analysi on astigmatism type and uncorrected distance visual acuity (UDVA) and found that age was considered a confounding f ctor within their analysis. As for long-term outcomes of toric IOL implantation, Prof. Oshika found in his studi s that eyes with preoperative WTR stigmatism and preoperative oblique astigmatism, vis on after toric IOL implantation remained stable over 8 years. However, eyes with preoperative ATR astigmatism experienced a reduced astigmatism-correcting effect after 5 years post-toric IOL implantation. “From these findings, we recommend overcorrection for ATR astigmatism,” said Prof. Oshika. Anot er topic Prof. Osh ka discusse was precis axis marki g. According to the ESCRS 2019 survey, 41% of ophthalmologists prefer ink marking using an aid instrument and 29% prefer ink marking at slit lamp without an aid instrument. Twenty-two percent (22%) prefer sing di ital image registration for aligning the toric IOL axis. Prof. Oshika noted that a recent study reported that digital marking is more time Supported by an educational grant from Johnson & Johnson Vision Long-term outcomes of toric IOL implantation shows stable vision for eyes with preoperative WTR and oblique astigmatism, while eyes with preoperative ATR astigmatism showed a reduced astigmatism-correcting effect after 5 years. Supple ent to Eye orld Asia-Pacific Septe ber 2022 In a variety of studies, Prof. Choi examined outcomes of visual acuity, uncorrected defocus curve, contr st sensitivity, digital reading speed test, questionnaires for subjective satisfaction, photic phenomena, and the visual functioning questionnaire (VFQ-25) for diffe ent IOLs including mix & match scenarios. Prof. Choi found positive outcomes in binocular vision for mix & match with TECNIS Symfony™ and +3.25, the PanOptix® IOL, another mix & match (ZEISS AT LARA and AT LISA tri IOLs), and t Synergy™ IOL, though the Synergy™ IOL showed superior outcomes to the other three scenarios. Additionally, the Synergy™ IOL showed higher uncorrected defocus curves and faster reading speeds than the other IOL scenarios. Furth rmore, mixing & matching the Synergy™ with Symfony™ or Eyhance™ provided promising uncorrected defocus curves. In summary, Prof. Choi emphasized the importance of comparing MTF curves of different IOLs (new IOLs may provide wider and higher energies in intermediate and near vision), the significance of surface roughness and optical scattering (regular surface patterns may better reduce surface scatterin ), and the advantage of full transmission of healthy blue light (provides bett r ontrast especially during night time). Finally, Prof. Choi said, “for a continuous range of vision with better near visual acuity, we need to individualize and optimize using a ‘combined’ implantation strategy.” Redefining Near Vision Needs with PresbyopiaCorrecting IOL Han Bor Fam, MBBS, MMed, FAMS, Singapore For Han Bor Fam, MBBS, MMed, FAMS, viewing distance is a significant factor for patients undergoing IOL implantation. In particular, cell phone viewing dis ances may range from 32 cm to 40 cm on average for hardcopy text, text messages, and text on the internet for A erican patients. However, because Chinese characters contain many strokes, viewing distance is estimated to be 33.95 cm. “What we really need [for our Asian patients] is a 33 cm to 36 cm viewing distance,” said Dr. Fam. “So, how do we allow these people to see better with IOLs?” The answer lies within a new IOL with certain limits. Ideally, this IOL would not have much loss in visual acuity across the defocus range. At minimum, Dr. Fam stated that the range should not be more than 0.2 logMAR between the best distance vision and near vision. Observing the TECNIS Multifocal® IOL, one can see, with diffractive multifocal technology, that this IOL provides good far and near distance vision but not good intermediate distance vision. With the Symfony™ IOL, an EDOF IOL, there is good far distance vision, but visual acuity tapers off rapidly at 1.5 diopters. With the Synergy™ IOL, though, the combination of diffractive multifocal technology with EDOF technology delivers continuous high-contrast vision across the functional range. The result for patients is peak Supported by an educational grant from Johnson & Johnson Vision MTF curves of three different trifocal IOLs. The TECNIS Synergy™ IOL covers a wide reading distance fr 33 cm to 27 cm. pti izing Patient utco es it Supplement to Eye orld Asia-Pacific September 2022
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