Eyeworld Supplements

6. Holladay JT, Piers PA, Koranyi G, et al. A new intraocular lens design to reduce spherical aberration of pseudophakic eyes. J Refract Surg 2002;18:683–91. 7. Packer M, Fine IH, Hoffman RS, Piers PA. Prospective randomized trial of an anterior surface modified prolate intraocular lens. J Refract Surg 2002;18(6):692–6. 8. Packer M, Fine IH, Hoffman RS, Piers PA. Improved functional vision with a modified prolate intraocular lens. J Cataract Refract Surg 2004;30(5):986–92. 9. Zhao H, Mainster MA. The effect of chromatic dispersion on pseudophakic optical performance. Br J Ophthalmol 2007;91(9):1225–9. 10. Laube T, Apel H, Koch HR. Ultraviolet radiation absorption of intraocular lenses. Ophthalmology 2004;111(5):880–5. 11. Nichamin LD, Chow DR. Violet-blocking: Balanc- ing retinal function and protection. B&L white paper. Nov 2006. www.premedpharma.hu/ftp/termekek- szemeszet/sofport/White-paper_Violet-Blocking.pdf 12. Mainster MA. Violet and blue light blocking intra- ocular lenses: photoprotection versus photoreception. Br J Ophthalmol 2006;90(6):784–92. 13. Henderson BA, Grimes KJ. Blue-blocking IOLs: a complete review of the literature. Surv Ophthalmol 2010;55:284–289. 14. Lai E, Levine B, Ciralsky J. Ultraviolet-blocking intraocular lenses: fact or fiction. Curr Opin Ophthalmol 2014;25(1):35–9. 15. Colin J, Praud D, Touboul D, Schweitzer C. Incidence of glistenings with the latest generation of yellow-tinted hydrophobic acrylic intraocular lenses. J Cataract Refract Surg 2012;38(7):1140–1146. 16. Behndig A, Mönestam E. Quantification of glistenings in intraocular lenses using Scheimp- flug photography. J Cataract Refract Surg 2009;35(1):14–17. 17. Matsushima H. Opacification of intraocular lenses. Film, ESCRS 2014. Accessible at escrs. conference2web.com/content/22769?from_prize- winners=vid&year= 18. Chang DH, Waring GO 4th. The subject-fixated coaxially sighted corneal light reflex: A clinical marker for centration of refractive treatments and devices. Am J Ophthalmol 2014;158:863–874. every eye. On my wish list would be a lens that can function in a fluid, dynam- ic way to compensate for SA and other aspects of the optical system that vary at different points of focus. Dr. Garg: I agree. What I really want in a lens is to duplicate the flexibility of focus, the optical clarity and quality, and the natural protections of the 20-year-old human lens. We are already very close to this goal, and I think we'll see more exciting developments in the next 15 to 20 years. Additionally, I think we'll continue to see more synergies between new IOL technology and developments in femto phaco surgery that will change how we think about cataract surgery. Dr. Chang: This has been a great discus- sion. We can certainly look forward to having greater functionality and options with new IOL designs in the future. As we evaluate those new lenses, I think it remains important to always go back to the basic question: What are the lens ma- terial properties and how do they affect image quality in the eye? If we keep that question in the forefront, we'll be able to continue refining cataract surgery and making the best IOL choices to meet our patients' visual goals for years to come. References 1. Erie JC, Bandhauer MH, McLaren JW. Analysis of postoperative glare and intraocular lens design. J Cataract Refract Surg 2001;27:614–21. 2. Erie JC, Bandhauer MH. Intraocular lens surfaces and their relationship to postoperative glare. J Cataract Refract Surg 2003;29:336–41. 3. Holladay JT, Zhao H, Reisin CR. Negative dysphotopsia: the enigmatic penumbra. J Cataract Refract Surg 2012;38(7):1251–65. 4. Guirao A, Redondo M, Geraghty E, et al. Corneal optical aberrations and retinal image quality in patients in whom monofocal intraocular lenses were implanted. Arch Ophthalmol 2002;120(9):1143–51. 5. Artal P, Berrio E, Guirao A, Piers P. Contribution of the cornea and internal surfaces to the change of ocular aberrations with age. J Opt Soc Am A Opt Image Sci Vis 2002;19(1):137–43. center the lens appropriately for the true visual axis. I always look at angle kappa preop. If it is >0.5 mm, I won't implant a multifocal IOL. Dr. Chang: We're just beginning to learn the impact of centration on visual quality. Many surgeons get confused when discussing the particulars of visual axis, line of sight, and angle kappa. That represents not a lack of knowledge but rather the fact that current definitions are too ambiguous to fully address this issue. That's why George O. Waring IV, MD, and I have proposed a new reference marker and terminology such as subject- fixated coaxially sighted corneal light reflex (SF-CSCLR), foveal fixation axis (FFA), and chord mu. 18 Dr. Chang: What do you think the future holds in terms of IOL materials and design? Dr. Wörtz: In general, I want to see lenses that provide better refractive outcomes by making it easier to hit the target of emmetropia. I'm very interested in the extended range of vision lenses that will be coming soon. These are very user-friendly lenses that increase the "sweet spot" but eliminate glare and halo. Dr. Ma: I agree. By taking advantage of the effect of diffractive gratings on chro- matic aberration, the new Symfony lens has the potential to provide true blend- ed vision for functional, spectacle-free vision without dysphotopsia or compro- mised contrast. It seems very promising to me. Oculentis (Berlin) and Morcher (Stuttgart, Germany) also have some new approaches to centration in the pipeline that will help us center IOLs based on the capsulorhexis instead of the capsular bag. And on a longer horizon, maybe 6 to 10 years away, I think we can look forward to new accommodative lens designs from several manufacturers. Dr. Kieval: I think we'll achieve some consensus on the ideal index of refrac- tion and Abbe number. Maybe we'll be able to customize spherical aberration to Copyright 2014 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or the publisher, and in no way imply endorsement by EyeWorld or ASCRS. 8

• Cover