These IOLs are made of a new hydrophobic acrylic material that is produced with an enhanced manufacturing process. I am excited for the impending release of both the Vivity and PanOptix on the Clareon IOL (Alcon) platform. As a result, patients-especially those with a history of refractive surgery-are less likely to experience glare, halos, or starbursts after surgery. I prefer the Vivity to other extended depth of focus IOLs because it has a visual disturbance profile similar to that of standard monofocal IOLs (data on file with Alcon). In my experience, patients who are not ideal candidates for multifocal IOL technology can be excellent candidates for the AcrySof IQ Vivity. If patients are happy with the range of vision in their first eye, however, I usually implant the AcrySof IQ Vivity bilaterally. In such situations, I prefer to implant an AcrySof IQ Vivity (Alcon) in the dominant eye and, if the patient requires more near vision, a PanOptix in the nondominant eye. Examples from my own experience include professional drivers, pilots, and law enforcement agents. I may consider mixing IOLs for patients who are concerned that visual dysphotopsias could affect their professional visual needs. Chair time has also decreased because additional discussion about range of vision with patients is no longer required at the 1-week postoperative visit. In my experience, the intermediate focal point (60 cm) of the PanOptix helps my patients achieve comfortable vision for computer work. I implant the PanOptix IOL bilaterally in most of my premium IOL patients because I know it can provide a continuous range of vision with few visual dysphotopsias. The FDA approval of the AcrySof IQ PanOptix trifocal IOL (Alcon) changed my presbyopia-correcting algorithm, and I now approach most cases with an IOL-matching strategy in mind. My patients achieved excellent outcomes and satisfaction with this approach, 1 but extended patient counseling was required between surgeries. If patients desired more near vision, however, I implanted a Tecnis Multifocal +3.25 D IOL in the nondominant eye as well. When patients were happy with their range of vision, I implanted a Tecnis Symfony IOL in the nondominant eye. I would then assess patient satisfaction and range of vision at the 1-week follow-up visit. When I used this strategy, which Johnson & Johnson Vision referred to as the personalized vision approach, I typically performed cataract surgery on the dominant eye first. Specifically, I implanted a Tecnis Symfony in the dominant eye and either a Tecnis Multifocal +3.25 D or a Tecnis Multifocal +4.00 D IOL (all IOLs from Johnson & Johnson Vision) in the nondominant eye. My Updated Presbyopia-Correcting Algorithmīefore a trifocal IOL became available in the United States, I routinely mixed and matched IOLs. Glaucoma Pipeline: A View Into Ongoing InnovationĬase Study Competition: Can This Patient Reach Spectacle Independence? IStent inject ® Pivotal Trial: Greater Efficacy and Better Patient-Reported Quality of LifeĮxtending the Range of Functional Vision for Cataract Patients Tools for IOL Selection: European Perspective The Positive and Negative Ripple Effects of Expanded IOL Optionsĭealing With Unhappy Premium IOL Patients The First Step to Educating Patients Is Understanding the TechnologyĪccommodating IOLs: Where Are We Now, and What’s on the Horizon? Sequential Customized Therapeutic Keratectomy The Hypermature Traumatic Cataract: Challenges Abound Toric IOL Rotation: Hypotheses, Mistakes, and Opportunity Immediate Sequential Bilateral Cataract Surgery The Evolving Landscape of Private Equity in Ophthalmology
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