Eyeworld Supplements

Supplement to EyeWorld February 2015 Premium care for your monofocal patients: Achieving optimal ELP with the AcrySof platform Sponsored by Alcon The AcrySof platform's exceptional design provides excellent vision across all AcrySof IOLs T he AcrySof platform (Alcon, Fort Worth, Texas) includes a family of IOLs that share the key components neces- sary to provide excellent IOL stability, IOL performance, and postoperative refractive outcomes. These components include highly bioadhesive hydrophobic acrylic material, a single-piece lens design, STABLEFORCE haptics, a yellow chromophore with blue light filtering properties, and a remarkably high index of refraction—all of which play a role in effective lens positioning (ELP) and better patient outcomes. Treating your monofocal patients Our first and foremost goal with cataract surgery is to provide our patients with the best possible vision after surgery. Our second goal with a cataract refractive procedure is to leave our patients with as little need for an optical device as possible. Today's monofocal patient may accept the need for spectacle correction, but he or she is understandably unwilling to rely upon them for every visual chore. In my practice, it is important for our monofocal patients to be just as pleased with their outcomes as our the lens slightly out of position via tilt or decentration. The STABLEFORCE haptics are designed to hold the lens in place; they're constructed of the same material as the lens itself. These haptics hold the center of the lens well and do not "let go" until the lens is actually fixated in place in the bag. Biocompatibility and fibronectin Early in my career, I was heavily involved in helping to design lenses that would be biocompatible—we used fluorocarbon coating on the lens or experimented with other substances we thought would work well. We evaluated explanted lenses (through cadaver donations or implanted/ explanted from rabbits) and created a solution that was fairly close to the components of the protein compo- nents inside the eye. We measured what kind of materials bound to the lens implant. We found a whole series of proteins, including fibronectin. Fibronectin is present in human serum. It's also present in the blood aqueous barrier around the eye and can bind to the lens implant. Because of its natural properties, fibronectin helps stabilize the lens in the bag. AcrySof is incredibly well tolerated be- cause it has the same protein that the body manufactures naturally, and has a high level of fibronectin bioadhesion. The AcrySof platform provides premium outcomes to satisfy the demands of our increasingly savvy patients—for every visual goal. Dr. Maxwell is a partner with Fogg, Maxwell, Lanier & Remington Eye Care in Fresno, Calif. He can be contacted at 559-449-5010 or amaxwellmd@gmail.com. Dr. Maxwell is a paid consultant and investigator for Alcon. Clinical update on blue light filtering and aspheric technologies This supplement was produced by EyeWorld and sponsored by Alcon. The doctors featured in this supplement received compensation from Alcon for their contributions to this supplement. Copyright 2015 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. www.eyeworld.org by Andrew Maxwell, MD, PhD premium lens patients. I think we can do that because of the design of the AcrySof lenses we implant. As surgeons, we have technology that helps us measure the length of the eye, the curvature of the eye, everything needed to calculate what the lens power implant should be. A very significant component in that is where does the lens fit inside the eye? If the lens shifts forward a little bit after implantation, the patient is a bit myopic. If the lens shifts backward a bit, the patient is a bit hyperopic. Effective lens positioning simply means the lens stays where we want it to be. All of our IOL calculation for- mulas presume that if we place a lens in the capsular bag, it will stay where placed and correct the refractive error we thought it was going to correct. With the AcrySof line, the bioad- hesive hydrophobic acrylic material has a little tackiness to it so the bag basically seals to it. In my hands, it means the lens sits where we predict it's going to sit, and I've rarely had any significant surprises. Those benefits work across the platform—so whether I'm using a toric lens or a monofocal or I'm using a femtosecond laser to create my capsulorhexis, these lenses end up where I expect them to be. Because the capsule shrinks around the lens so quickly, the lens doesn't have a lot of variability whether it's going to shift backward or forward. The role of the haptics The STABLEFORCE haptics have a specific amount of compression force that helps fixate the lens in the bag and do not lose that compression force. Before this technology was available, we had lenses with haptics that would lose that compression force within 24 hours, essentially shifting

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