With rising visual demands and an active lifestyle among older patients, the need for functional vision and spectacle independence at near, intermediate and distance vision is increasingly important today.
Alcon offers innovative approaches to presbyopia correction with its market-leading intraocular lens (IOL) technologies, as well as the ARGOS® swept source optical coherence tomography (SS-OCT) biometer as a smart planning solution.
During a session called Alcon Innovations in Advancing Patient Outcomes during the 34th Annual Meeting of the Asia-Pacific Association of Cataract and Refractive Surgeons (APACRS) in June 2022, renowned international experts shared their views on Alcon’s AcrySof® IQ Vivity, Clareon® PanOptix trifocal IOL, Clareon® Monofocal IOL on the new Monarch® IV Delivery System as well as ARGOS® – Alcon’s Biometer.
AcrySof® IQ Vivity: The First of its Kind Presbyopia Correcting IOL, with X-WAVE Wavefront Shaping Technology
The optical designs and materials used in Alcon’s IOLs provide patients with a variety of options to see better, thanks to its commitment to innovation. One example of this is their AcrySof® IQ Vivity IOL: The first of its kind presbyopia-correcting IOL with wavefront-shaping technology and a clinically-proven, exceptionally low rate of visual disturbances.1
Dr. Rudy Nuijts, MD, professor of ophthalmology and director of the Cornea Clinic and the Center for Refractive Surgery at the Department of Ophthalmology, University of Maastricht, the Netherlands, discussed how the AcrySof® IQ Vivity IOL meets the needs of diverse patients.
Data showed that good uncorrected distance visual acuity (the primary performance endpoint) was observed at 3 to 6 months after AcrySof® IQ Vivity IOL implantation, said Dr. Nuijts. An average of -20/20 Snellen (0.14 to 0.035 logMAR) was demonstrated in the overall cohort2, according to results from the Vivity Registry Study looking at the real-world performance of the AcrySof® IQ Vivity and Vivity Toric IOLs in routine clinical practice.
Further, exploratory performance outcomes at 3 to 6 months after AcrySof® IQ Vivity IOL implantation demonstrated an average of ~20/20 to 20/25 (0.074 to 0.099 logMAR) for uncorrected intermediate visual acuity (VA) and an average of ~20/32 to 20/40 (0.204 to 0.271 logMAR) for uncorrected near VA.2
Results reveal that the AcrySof® IQ Vivity has led to positive outcomes for both monovision and glaucoma patients.2 Patients can achieve good VA with a high chance of being spectacle-free, with the monovision approach. More patients meeting the criteria for monovision reported that they were able to read a newspaper without difficulty compared with the overall cohort. Using it on glaucoma patients also showed good results, similar to the overall cohort – 83.3% or 15 out of 18 patients in this cohort were very satisfied with their sight. No patients with glaucoma reported starburst, and most reported no halo or glare. Overall, 91.5% of patients were reported to be satisfied, with the majority of patients having no visual disturbances at 3 to 6 months2 after AcrySof® IQ Vivity IOL implantation.
He also shared his personal experience of a case involving a 26-year-old male, one of his first using the AcrySof® IQ Vivity. The patient had a steroid- induced cataract and anterior uveitis and was very happy with the results at the 3-month follow-up: uncorrected distance VA of 20/20, uncorrected intermediate VA of 20/25, and uncorrected near VA of 20/40. He experienced no visual disturbances.
Clareon® PanOptix Offers Full Range of Vision
The Clareon® family of intraocular lenses delivers excellent vision, exceptional clarity and predictable refractive outcomes. These IOLs offer sharp, crisp vision with a proprietary edge designed to help reduce glare and posterior capsular opacification.3 Plus, the lens’ unique and proven STABLEFORCE® haptics provide superior axial and rotational stability.4-8
The Clareon® PanOptix trifocal is made from a glistening-free IOL material that has among the lowest levels of haze and subsurface nano glistenings (SSNGs) compared to leading competitor IOLs.9-10
According to Dr. Myong Joon Kim from Renew Seoul Eye Center, Seoul, South Korea, Clareon® PanOptix provides the full range of vision – bifocal IOLs often provide poor intermediate vision, while trifocal IOLs offer unsatisfactory intermediate vision. Newer trifocal IOLs offer a full range of vision especially within arm’s length, the optimal distance for daily intermediate vision tasks for most people. “Although the Vivity is a fast-growing rookie, the PanOptix is a proven star and the PanOptix is still evolving,” Dr. Kim said.
He said he has used 100 Clareon® PanOptix lenses, and his first impressions are that “the refractive outcomes were excellent” and he used the Alcon online toric calculator which worked “very well.”
Clareon® Monofocal IOL Delivers Uncompromising Outcomes
The Clareon® IOL is Alcon’s newest material formulation that combines advanced lens design with exceptional visual performance, building on the proven success of the AcrySof® IQ biomechanics and bio-optics.
Clareon® monofocal IOLs provide extraordinary clarity, delivering long- lasting refractive outcomes that monofocal patients expect.9-10 Clareon® IOLs are inserted using the next- generation, reusable Clareon Monarch® IV Delivery System, which provides precise and controlled implantation and that, was designed specifically for the new Clareon® material.
For Dr. Terry Kim, MD, professor of ophthalmology at the Duke University School of Medicine, USA, Clareon® is the “uncompromised IOL platform of choice.” Its enhanced IOL design has a fully usable 6 mm aspheric optic dedicated to sharp, crisp distance vision from edge to edge.
“Alcon’s newest hydrophobic biomaterial of optimized clarity is glistening-free with the lowest levels of haze and SSNGs9-10,” said Dr. Kim, adding that no glistening and surface light scattering reported in a study makes it “a truly pristine IOL.” Its ultra-smooth optic delivers among the lowest levels of surface haze of competitive monofocal IOLs. The Clareon® IOL is also designed for maximum refractive predictability and superior axial stability.4, 11
The Clareon® IOL features a precision edge design that guards against posterior capsule opacification (PCO), and minimizes Nd-YAG rates. The IOL improves upon the low Nd-YAG rates of AcrySof® lenses.12-13 “This lens platform has excellent rotational stability4, 14, which is of course very critical,” he added.
“In summary, it’s exciting to see Alcon give to us another step of improvement in terms of monofocal IOLs, and with the Clareon® IOL, you are going to see not only the glistening-free optic, but also lower PCO rates, and rotational stability, as well as actual stability with that fully usable optic that will give us superior results.”
Faster, Easier, Better – with ARGOS Biometer
The ARGOS® biometer offers accuracy, efficiency and connectivity in biometry, said Dr. David Lubeck, MD, founder of Arbor Centers for EyeCare, USA.
It takes less than a second for the ARGOS® to capture data including antechamber depth, keratometry, corneal diameter, central corneal thickness, axial length, aqueous depth, pupil size, lens thickness, limbal registration, visual axis and pupil centration15, he said.
“Also incredibly impressive is the acquisition rate in dense cataracts and with this device, there is a 41% higher acquisition rate in grade four cataracts than the IOLMaster 70016,” he said.
Results from a real-world study demonstrate that the ARGOS® delivers significant time efficiency for dense and non-dense patients in cataract evaluation, surgical planning and outcome management.17 “This technology provides faster and more accurate biometric measurements, robust surgical planning, intraoperative data transfer and integration guidance,” he said.
Image guidance by Alcon uses a patient’s eye reference image — its unique iris and limbal landmarks — in order to provide real-time navigation for the precise execution of a surgical plan. It also reduces the risk of transcription errors, and enhances refractive outcomes. In short, the ARGOS® biometer provides faster preoperative measurements than market-leading biometers with built-in image guidance, and has better acquisition rates through dense cataracts.
It’s also fully integrated with the Alcon Cataract Refractive Suite for greater efficiency and provides easier access to planning data with convenient, one- touch software. “The ARGOS® improves the way we execute and implement preoperative surgical planning and postoperative outcomes management,” said Dr. Lubeck.
Editor’s Note: The Alcon Lunch Symposium was held on June 12, 2022 during the 34th Annual Meeting of the Asia- Pacific Association of Cataract & Refractive Surgeons (APACRS 2022). Reporting for this story took place during the event.
1. Bala C, Poyales F, Guarro M, et al. Multicountry clinical outcomes of a new nondiffractive presbyopia-correcting IOL. J Cataract Refract Surg. 2022;48(2):136-143.
2. Alcon Research LLC ILE871-P001 second interim database lock. Data on file. 2022.
3. Das KK, Werner L, Collins S, Hong X. In vitro and schematic model eye assessment of glare or positive dysphotopsia-type photic phenomena: Comparison of a new material IOL to other monofocal IOLs. J Cataract Refract Surg. 2019;45(2):219-227.
4. Lane S, Collins S, Das KK, et al. Evaluation of intraocular lens mechanical stability. J Cataract Refract Surg. 2019;45(4):501-506.
5. TDOC-0054028 (2017) – Clareon SY60WF Axial Displacement Study at Varied Compressions.
6. Kramer BA, Hardten DR, Berdahl JP. Rotation Characteristics of Three Toric Monofocal Intraocular Lenses. Clin Ophthalmol. 2020;14:4379-4384.
7. Lee BS, Chang DF. Comparison of the Rotational Stability of Two Toric Intraocular Lenses in 1273 Consecutive Eyes. Ophthalmology. 2018;125(9):1325-1331.
8. Oshika T, Fujita Y, Hirota A, et al. Comparison of incidence of repositioning surgery to correct misalignment with three toric intraocular lenses. Eur J Ophthalmol. 2020;30(4):680-684.
9. Lehmann R, Maxwell A, Lubeck DM, Fong R, Walters TR, Fakadej A. Effectiveness and Safety of the Clareon Monofocal Intraocular Lens: Outcomes from a 12-Month Single-Arm Clinical Study in a Large Sample. Clin Ophthalmol. 2021;15:1647-1657.
10. Werner L, Thatthamla I, Ong M, et al. Evaluation of clarity characteristics in a new hydrophobic acrylic IOL in comparison to commercially available IOLs. J Cataract Refract Surg. 2019;45(10):1490-1497.
11. Clareon Toric IOL DFU. Alcon Data on File TDOC 0054028
12. Clareon Monofocal IOL DFU SY60WF (v1.0). Alcon Data On File TDOC 0053598
13. AcrySof IQ DFU. Clareon Toric IOL DFU. Alcon Data On File TDOC 0054028
14. Clareon Monofocal IOL DFU SY60WF (v1.0). Alcon Data On File TDOC 0053598
15. Alcon Data on File.
16. Tamaoki A, Kojima T, Hasegawa A, et al. Clinical evaluation of a new swept-source optical coherence biometer that uses individual refractive indices to measure axial length in cataract patients. Ophthalmic Res. 2019;62:11-23.
17. Multack S. Time Efficiency Metrics of an Innovative Swept Source OCT Biometer (SS- OCT) for Cataract Evaluation: A Comparative Time-and-Motion Study. ASCRS, Washington D.C. 22 April 2022.