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    Innovations change face of modern cataract surgery

    Evolution continues in 2017 with techniques, technologies


    Presbyopia correction

    After receiving FDA clearance for marketing in July 2016, the Tecnis Symfony Extended Range of Vision IOL and Tecnis Symfony Toric IOL (Johnson & Johnson Vision) seemed to hit the ground running.

    Dr. Donnenfeld considers the Symfony IOLs an enormous improvement in presbyopia correction.

    “In the course of 1 year, this technology became the most used presbyopic IOL in the United States, and it has grown the market by 50%,” he observed. “The Symfony Toric IOL was the first diffractive toric IOL in the United States, and it is the only lens available here that corrects for chromatic aberration to improve contrast sensitivity.”

    Dr. Packer thought that the trend for growth in Symfony IOL sales was slowing because of the realization that patients still can experience nighttime glare and halos.

    “The Tecnis Symfony IOLs maintain an advantage over the other available multifocal IOLs in this regard, and they are definitely getting a lot of use,” Dr. Packer said.

    During the ESCRS meeting, Dr. Packer said he conducted an informal poll of European surgeons to find out which of the many lenses that are available outside of the United States they prefer. The lens named most often was the Fine Vision trifocal, which seems to meet patients’ interest in achieving spectacle independence at all distances even though it does not overcome the problems of contrast loss and unwanted optical side effects.

    “The trifocal design seems to be doing a better job than other lenses in eliminating the dip in the defocus curve at arms-length distance, which is right where the computer screen is,” Dr. Packer said.

    The lens with the second-most mentions by European surgeons was the Acri.LISA multifocal (Carl Zeiss Meditec), followed by the Lentis MPlus (Oculentis). Dr. Packer noted that when the latter IOL was launched, there was some thought that it would be free of dysphotopsias, but symptom reports have emerged.

    “It seems that whatever the optic design, surgeons implanting presbyopia-correcting IOLs should count on spending some extra chair time for patient selection and counseling, and anticipate some explantations in dissatisfied patients,” Dr. Packer said.

    The trifocal PanOptix IOL from Alcon Laboratories will likely be the first trifocal IOL to come onto the U.S. market, he said.

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