Alcon at APACRS 2023: IOLs, Microscopes, Live Surgery, and Glaucoma Devices APACRS avoid those patients. “If you look at higher order aberrations, you want to ensure patients don’t have them because of the steep defocus curve of the lens,” she said (see Figure1). Finally, patients will need to be tolerant of some degree of halo and possibly mild glare. The surgeon should also consider the additional chair time needed, the need for accurate biometry, and “the need to be competent with toric correction,” she said. The Vivity lens is based on X-Wave technology that provides continuous depth of focus. The central 2.2 mm is a 1 µm plateau consisting of two smooth transition elements. The first transition element alters the wavefront stretching the light as it enters the eye from a distance and as light is stretched, it collapses on itself as it enters the eye, forming the continuous light needed for intermediate and distance vision. The second transition element is the curvature that delays and shifts the wavefront so when light passes through the lens it takes on the shape of the profile of the lens and as it collapses on itself and folds on itself, it forms the continuous light in focus for near to intermediate distance. “Importantly, there is no splitting of light,” Dr. Phaik said. “All the light that passes through the lens is stretched,” making it act more like a monofocal lens. 6 Other advantages include less susceptibility to decentration and good contrast sensitivity. Integrating the lens into her practice has been smooth — the lens is suitable for patients who desire continuous vision from distance to intermediate and functional near vision, but should also be considered for patients who may not be candidates for other advanced technology lenses because of dry eye, mild optic nerve or macular disease, or post-corneal refractive surgery. She said the Vivity lens should not be implanted in patients with a desire for prolonged close vision or in those who have severe loss of central vision. Prof. Kohnen noted extended depth of focus (EDOF) lenses provide excellent distance vision, improved vision The news magazine of the Asia-Pacific Association of Cataract & Refractive Surgeons 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. Not all products, services or offers are approved or offered in every market and approved labeling and instructions may vary from one country to another. The statements of the authors of this supplement reflect only their personal opinion and experience and do not necessarily reflect the opinion of Alcon or any institution with whom they are affiliated. Alcon has not necessarily access to clinical data backing the statements of the authors. The statements made by the authors may not yet been scientifically proven and may have to be proven and/or clarified in further clinical studies. Some information presented in this supplement may only be about the current state of clinical research and may not be part of the official product labeling and approved indications of the product. The authors alone are responsible for the content of this supplement and any potential resulting infringements resulting from, in particular, but not alone, copyright, trademark or other intellectual property right infringements as well as unfair competition claims. Alcon does not accept any responsibility or liability of its content. in the intermediate range, functional near vision, but the optical quality and phenomena depend on the lens design itself. 7 In his first 16 patients (32 eyes) 8 with the Vivity “what was astonishing was first, we had a very nice defocus curve,” he said, “and very good subjective quality of vision, even night driving.” The lens produced substantially less halo than other diffractive technologies; the only detractor is “we cannot achieve near VA perfectly." The Vivity Registry Study, a multicenter, non-comparative, open-label, non-interventional registry study 20, was designed to evaluate photopic binocular uncorrected VA at a distance after bilateral implantation with either the Vivity or Vivity toric lens between June 2020 and December 2022. The registry included 41 sites from Europe, Australia, and New Zealand and comprised 910 patients, the majority of whom were ≥ 65 years old (64.7%), female (56.3%), and white (97.6%). More than 84% of the eyes had < 0.5 D of manifest refraction at the study entry visit (after implantation of the lens). At study entry, 884/910 (97.1%) of patients had an uncorrected distance VA of 0.009±0.0998 logMAR (20/20 Snellen); all but one patient had an intermediate VA (66 cm) of 0.084 logMAR, and every patient had a near VA (40 cm) of 0.25 logMAR (about 20/25 Snellen); see Figure 2. Most patients did not need spectacles for distance, intermediate, or near in either bright (88.2%, 78.2%, 48.3%, respectively) or dim conditions (85.2%, 68.3%, 31%, respectively). Further, of the patients who responded to the Catquest-9SF At this year’s APACRS 2023, Alcon hosted multiple booth talks and a live surgery lunch symposium. Here are some of the highlights. IOLs Both Dr. Chee-Soon PHAIK (Singapore) and Prof. Thomas KOHNEN (Frankfurt, Germany) discussed Alcon’s newest presbyopia-correcting intraocular lenses (IOLs). Dr. Phaik offered tips on patient selection for both the Clareon PanOptix and AcrySof IQ Vivity lenses, while Prof. Kohnen discussed real-world registry data on the Vivity lens and offered personal insights from his experiences with the lens. The PanOptix is a diffractive trifocal IOL that splits light 1, resulting in an 88% light transmittance. “This means we need to screen the eye, select perfectly normal eyes, and counsel patients carefully,” Dr. Phaik said, noting that doing so results in spectacle freedom 90% of the time. 2-5 She added the importance of screening the optic nerve (not just the macula) with an optical coherence tomographer (OCT) and examining the ocular surface to ensure the patient has little inflammation and good tear film. Dr. Phaik excludes patients who have undergone previous refractive surgery, and recommends surgeons who are just beginning to include trifocal lenses also FIGURE 1. The PanOptix has a steep defocus curve
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