During the panel discussion, an audience member asked whether mixing and matching the TECNIS Eyhance™ and Synergy™ IOLs was an issue for the patient regarding contrast. Dr. Rojanapongpun replied that the patient did not complain about contrast and color differences. “After a while, they may forget about it. It could be neuroadaptation,” he said. If the patient did come back and complain, what would he do? “I would try to persuade the patient not to do anything if overall the surgery has been successful in terms of visual outcomes. But if it’s really a problem, do I have to do an IOL exchange for both eyes? Yes; there are very few cases that I have to do an exchange. Ultimately, it depends not on the number. It depends on the happy patient.” Clinical Experience Copyright 2023 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. 2023 PP2023MLT6431 “ Patients will have to give up something to gain something. Discuss a compromise with the patient. Surgeons should work with the patient to achieve a good balance of happiness in the outcome of the surgery. ” Prin ROJANAPONGPUN, MD Thailand Using TECNIS Synergy™: Continuous Range of Vision PCIOL vs. Trifocal Hiroko BISSEN-MIYAJIMA, MD, Japan Hiroko Bissen-Miyajima, MD (Japan) brought her experience of using the TECNIS Synergy™ IOL to share with attendees. Presbyopia-correcting IOLs (PC IOLs) have been developing over the last 20 years with most of the technological changes being made due to patient needs. The TECNIS Synergy™ IOL is a mixture of two lenses: a diffractive bifocal IOL and an EDOF IOL. While the EDOF IOL provides good distance and intermediate vision along with good contrast sensitivity, patients may still need reading spectacles. The combination of the EDOF IOL with the diffractive bifocal IOL provides the near vision that the EDOF IOL alone lacks. “Synergy™ has the optical benefit of both IOLs,” Dr. Bissen-Miyajima said. The TECNIS Synergy™ IOL gives patients continuous vision from distance to near and provides superior image contrast in all lighting conditions by modifying chromatic aberrations. Furthermore, patients may experience less dysphotopsia through violet light filtration technology. For a patient who has healthy eyes, Dr. Bissen-Miyajima usually implants Synergy™. However, if a patient presents with ocular comorbidities such as glaucoma or previously the script of Asian languages is so complex and small, this population of patients needs stronger near vision and good intermediate vision. Dr. Rojanapongpun believes that the TECNIS Synergy™ IOL fulfills this unique need of the Asian population. Synergy™ provides the widest range of continuous vision with high-quality near vision. At the same time, this IOL provides superior contrast during the day and night. The TECNIS Synergy™ IOL is the most advanced IOL yet, going beyond trifocal technology. “Getting a happy patient takes passionate practice, communication skills, and a depth of knowledge and experience,” Dr. Rojanapongpun said. By making a goal-based decision with the patient, surgeons will be more equipped to produce outcomes and satisfy patients’ needs. Perhaps some patients require perfect clarity or complete spectacle freedom. Some patients may want an outcome that lies in between visual clarity and spectacle freedom. Thus, it is crucial for surgeons to have the discussion with the patient to meet their needs. both eyes, and 20/32 uncorrected near visual acuity at 33 cm for both eyes) and was very happy with her results. Her combined defocus curve at 1 month after surgery showed that although the distance-corrected defocus curve for the eye implanted with the Eyhance™ IOL dropped off at near vision, the eye implanted with the Synergy™ IOL maintained good near visual acuity. Combining the two IOLs allowed for the patient’s defocus curve to keep good near visual acuity. Another benefit of the TECNIS Synergy™ IOL that Dr. Rojanapongpun appreciates is its bio-polymer material. With a legacy of 20 years, the TECNIS™ bio-polymer material has no glistening, no surface discoloration, a low refractive index, a consistent A-constant, and reduced capsule contraction. Additionally, the lens merges the diffractive and extended depth of focus (EDOF) properties with chromatic aberration correction, which helps widen the range of focus and maintain a high quality of vision. In the Asian population, there are other challenges surgeons have to think about. Because
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