45 EyeWorld Asia-Pacific | September 2024 not many had a problem with halos, starbursts, and glares. The results showed that more than or equal to 98.3% of patients who experienced halos, starbursts, or glares “often” or “always” were not bothered or were slightly bothered by these visual symptoms. Statistically, there was no difference between the TECNIS PureSee™ IOL and the TECNIS Eyhance™ IOL in terms of bothersome symptoms.1,2 Furthermore, 88.3%, 96.7%, and 100.0% of patients reported that they never, rarely, or sometimes experienced halos, starbursts and glare, respectively.1 “My early experience has been positive,” Dr. Roberts remarked. “The common unsolicited feedback I hear from patients is that ‘I can see well over a range of vision, and my distance vision is lovely and clear.’” Dr. Roberts also found that patients experienced minimal to no dysphotopsia. “Day to day, it’s a pretty robust lens.” “I have had the pleasure to be among the first in Europe to use the TECNIS PureSee™ IOL,” Dr. Auffarth remarked. “I was able to implant 18 lenses.”3 From case videos, Dr. Auffarth shared various tips for a smooth surgical experience. “When I do this kind of premium IOL cataract surgery, I like to have a nice capsulotomy, and I may use a femtolaser,” he said. “It is important to secure the lens in the capsular bag. I usually center the lens on the horizontal plane, but you can do it as you like. Keep the rhexis and lens centered with some small overlap. Then, you will have the best options for long-term outcomes. Removing the viscoelastic is also important.” Finally, the hydrophobic acrylic material, Dr. Auffarth explained, tends to result in less posterior capsule opacification (PCO), especially for the first three to five years. The TECNIS PureSee™ IOL implanted in 18 eyes3 by Dr. Auffarth himself resulted in a mean uncorrected distance visual acuity (4 m) of 0.02 logMAR and a mean uncorrected near visual acuity (40 cm) of 0.30 logMAR at 3 months after surgery; most of the patients with residual refractive error in one or both eyes did not need spectacles and were satisfied with their distance vision. “We are very happy with the first implantations,” Dr. Auffarth said. “Vision quality is excellent, and patients are very happy. There will be a future with this type of IOL.” Tae-im Kim, MD, PhD (South Korea) shared similar experiences with that of Dr. Roberts and Dr. Auffarth. “The continuous range of vision is very important in order to meet patients’ expectations,” she said. For Dr. Kim, dysphotopsia is the major obstacle with multifocal IOLs. “Even though we try our best, we can’t reach perfect vision. Some residual astigmatism and residual refractive errors always interfere with a patient’s performance of vision,” she said. However, Dr. Kim’s experience with TECNIS PureSee™ “makes us feel better with minimized dysphotopsia and extended tolerance of residual refractive errors,” she said. Although Dr. Kim remains careful with optimizing her IOL centration technique, the increased tolerance of the TECNIS PureSee™ allows her to perform surgery with more ease, unlike other IOLs. “It makes me feel more comfortable with the surgery.” “Now, in my patients, I implant 30% TECNIS PureSee™ IOLs, 30% TECNIS Eyhance™ IOLs, and the remaining receive a monofocal IOL,” Dr. Kim explained. Though she does not implant TECNIS PureSee™ in patients with retinal comorbidities such as maculopathy, “I try to persuade my patients that the TECNIS PureSee™ is a good option because you can minimize photic phenomenon and you can have EDOF for daily life.” Dr. Gerd stated that he implants 50% TECNIS PureSee™ and 50% trifocal lenses. “Now that the refractive technology is catching up, we are getting to the point where trifocal is not as dominant,” he said. Potential Entry-Level PCIOL Dr. Roberts believes the data is very strong for patients who are slightly hyperopic, and early results have shown strong consistency and predictability in the range of vision for patients. “This could be a good lens for surgeons to move from monofocal to presbyopia-correcting lenses,” he said. For surgeons who are only using monofocals, Dr. Roberts suggests that if a surgeon introduces the TECNIS PureSee™ into his or her practice by carefully selecting patients with healthy eyes that are slightly hyperopic, “you will get very happy patients, very few negative comments in your waiting room, and a greater lifestyle outcome without introducing bothersome glares and halos.” As Dr. Auffarth also pointed out, the best patients suited for the TECNIS PureSee™ IOL include those who are hyperopic, emmetropic, and myopic with refractive tolerability, though reading spectacles for patients may be selectively required. Patients who participate in sports and outdoor activities, patients who perform computer and/or desktop work, and patients who drive cars may find good outcomes with the TECNIS PureSee™ IOL, especially with the very low risk for dysphotopsia. “You will get predictable results; it’s a good robust lens on a familiar IOL platform with routine biometry and calculations,” Dr. Roberts added. “My early experience will be considering the TECNIS PureSee™ IOL as a first line lens for cataract patients who want lifestyle vision and don’t want to compromise quality of vision.” References: 1. Corbett D et al. Quality of vision clinical outcomes for a new fullyrefractive extended depth of focus Intraocular Lens. Eye (Lond). 2024; 38(Suppl 1):9-14. 2. Black DA et al. Tolerance to refractive error with a new extended depth of focus intraocular lens. Eye (Lond). 2024;38(Suppl 1):15-20. 3. Data on file at International Vision Correction Research Centre (IVCRC). In a proof-of-concept study of 117 patients, the monocular range of vision at 0.2 logMAR was 0.7 D larger in patients implanted with the TECNIS PureSee™ compared to those implanted with the TECNIS Eyhance™ 6 months after surgery. Copyright 2024 APACRS. 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, Asia-Pacific or APACRS. All other trademarks are the intellectual property of their respective owners. © Johnson & Johnson Surgical Vision, Inc. 2024 2024PP14353 “TECNIS PureSee™ can be a good lens for surgeons to move from monofocal to presbyopia-correcting lenses Dr. Tim Roberts Dr. Gerd Auffarth Dr. Tae-im Kim ” Media placement sponsored by Johnson & Johnson | Vision
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