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Digital Supplement | Sponsored by Alcon

I Waited Until I Found the Right Technology to Offer my Patients

I am considered by my colleagues as a “late adopter” to implanting multifocal IOLs. It wasn’t until I felt comfortable that I could address patients’ lower order aberrations through both sphere and cylinder correction did I decide to evaluate the different multifocal lenses.

My ACTIVEFOCUS optical design story began when I decided to jump with both feet into the multifocal lens technology arena when the AcrySof IQ ReSTOR +2.5 D IOL with ACTIVEFOCUS optical design was introduced. After the toric version of this lens became available in 2017, I began my journey to offering patients more than just distance vision IOL options.

One of my first patients to receive a AcrySof IQ ReSTOR +2.5 D Toric IOL with ACTIVEFOCUS optical design was a young man in his mid-30s who had been electrocuted during an accident while on the job and luckily survived. However, perhaps as a consequence of the accident, his vision started to deteriorate much more quickly than normal, and he was subsequently diagnosed with early-onset cataracts.

After hearing about his visual goals, and because of preexisting bilateral astigmatism, I recommended the AcrySof IQ Toric IOL. My previous experience with AcrySof IQ Toric lenses suggested to me that the newer model would provide excellent rotational stability. Indeed, a recent study found that AcrySof IQ Toric lenses are less likely to rotate, and critically, that they are unlikely to rotate beyond 5 degrees.1

The AcrySof IQ ReSTOR +2.5 D IOL with ACTIVEFOCUS optical design has become my go-to lens for patients who want increased independence from wearing glasses after cataract surgery (Figure).2-4 The availability of the toric model allows me to offer these same potential benefits to patients with astigmatism.

Figure. Comparison of peak near performance with on-market presbyopia-correcting IOLs.2-4

I have since refined my patient selection criteria even further, and I have been impressed with the intermediate vision that my patients have after bilateral implantation. The AcrySof IQ ReSTOR +2.5 D IOL with ACTIVEFOCUS optical design and its toric version have definitely enabled me to meet the demands of my patients’ visual goals and also have fewer complaints regarding glare and halos.5

My young patient recently returned for an annual exam. He has achieved a full range of vision and, because of the rotational stability of the AcrySof IQ Toric IOL, his prognosis for maintaining that same vision long-term is positive. Perhaps more importantly, he is still enthusiastic about his vision and being able to live an active lifestyle without having to wear glasses for his professional responsibilities.

1. Lee BS, Chang DF. Comparison of the rotational stability of two toric Intraocular lenses in 1273 consecutive eyes. Ophthalmology. 2018 Mar 12. pii: S0161-6420(17)33524-8. doi: 10.1016/j.ophtha.2018.02.012. [Epub ahead of print]

2. AcrySof IQ ReSTOR +2.5 D IOL Directions for Use.

3. AcrySof IQ ReSTOR +3.0 D IOL Directions for Use.

4. TECNIS** Symfony** Extended Range of Vision IOL Directions for Use.

5. Alcon Data on File (Oct. 6, 2016).

AcrySof, ACTIVEFOCUS and ReSTOR are trademarks of Novartis. All other brand/product names are the trademarks of their respective owners.

Brandon D. Ayres, MD
  • Surgeon in the Cornea Service, Wills Eye Hospital, Philadelphia
  • bayres@willseye.org
  • Financial disclosure: Consultant (Alcon)