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| SUPPLEMENT TO EYEWORLD DAILY NEWS, MAY 6, 2023 Going beyond: Unique technologies designed to help your patients see brilliantly 2 The Clareon collection: more options for more patients Priya Mathews, MD, MPH P riya Mathews, MD, MPH, thinks offering presbyopia-cor- recting IOLs is vital for a well-rounded practice, and having experience and understanding with a range of IOLs allows her to customize her patient selection according to individ- uals' visual needs and goals. "It is important as an ophthalmologist to have these options for our cataract patients because at the end of the day, we are trying our best to achieve their goals for after surgery with the available technologies," she said. "Once I understand the whole picture of 1) the patient's anatomy, 2) the patient's occupation and personality, and 3) their goals for after surgery, I will select the best presbyopia-correcting lens to achieve that goal. The more op- tions I have, the better I can meet the individual patient's goals." Dr. Mathews said once she started out in private practice, she found there was strong patient demand for presbyopia-correcting lenses. "I realized that the patient demographics in private prac- tice were very different compared to academics. There were many patients who wanted to be free of glasses," she said. "Therefore, I quickly integrated presbyopia-correcting IOLs into my practice, and I recognize that it is crucial to stay up to date with the latest technologies available." Dr. Mathews offers a full range of presbyopia-correcting IOLs—the Vivity IOL (Alcon), the PanOptix IOL (Alcon), and others. "There's certainly a huge benefit in offering different lens technologies in your practice," she said. "As cataract surgeons we are obliged to understand the different lens technologies that are available and the pros/cons of each lens. There is no perfect lens, but you can certainly optimize your outcome by knowing which variables make a patient a better or worse candidate for a particu- lar lens technology," she said. Dr. Mathews begins her patient selection with a review of patient testing before she even walks into a consultation and exam. This includes biometry, topography, specular microscopy, OCT of the macula, and ultra-widefield retinal imaging. This gives her an idea of potential IOL options for the patient to help direct discussions. Afterward, she performs a careful slit lamp examina- tion, which could further narrow down IOL options. Finally, she'll listen to the patient's goals and lifestyle. "By the end of my conversation, I decide what lens technolo- gy is the best fit for that patient. I document the final decision in the chart before I walk out of the room so that there is no question about it later," Dr. Mathews said. Dr. Mathews thinks the PanOptix IOL works well in patients whose optical systems are "almost perfect from front to back." "As a cornea specialist, I think that the ideal trifocal candidate should have minimal to no irregular astigmatism, low higher order aberrations, and some people factor chord mu into their decision as well," she said. The PanOptix IOL was the first trifocal IOL approved by the FDA in 2019. 1 It is de- signed to deliver a full range of vision with minimal disturbances, with 20/20 near, inter- mediate, and distance vision. 2 *† Proprietary ENLIGHTEN Optical Technology with this IOL allows for optimal intermediate vision with uncompromised intermediate and distance vision. 3,4 Of patients who have the PanOptix IOL, 99.2% said they would have the same lens implant- ed again. 5 ‡ Dr. Mathews finds the Vivity IOL more forgiving if a patient has pathology, though she won't select any of these presbyopia- correcting IOLs if there is retinal pathology. The Vivity IOL was approved by the FDA as the first non-diffractive, extended depth of focus (EDOF) IOL in 2021. 6 With X-WAVE technology, this lens is designed to provide monofocal-quality distance visual acuity, stretching and shifting light without splitting it, and excellent intermediate and functional near vision. 7 †‡ Of patients who have received the Vivity IOL, 94% and 92% reported good or very good distance vision and intermediate vision, respectively, without glasses in bright light (20/20 at distance and greater than 20/25 at intermediate).†‡ "I do prefer this EDOF lens in patients with mild to moderate irregularities of the cornea,"** Dr. Mathews said. "The Vivity IOL is also my lens of choice in patients who want to be mostly glass- es-free but who are OK with possibly needing 'cheaters' and who are concerned about the possibility of halos after surgery." Dr. Mathews doesn't use multifocal technologies for patients with any significant irregular astigmatism. The fact that the PanOptix IOL and the Vivity IOL are now available on the Clareon IOL platform (Alcon), which is composed of a new glistening-free biomaterial, 8,9,10 *** has influenced Dr. Mathews' use of these options, and she's had positive results so far. "I am more comfortable offering the Clareon IOLs in my practice now," she said. "The older biomaterial affected my decision about implanting these lenses. We owe it to our patients to use materials that will be safe and effective in the years ahead." continued on page 5 The Clareon® PanOptix® Toric IOL (left) and the Clareon® Vivity® Toric IOL (right) Source: Alcon

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