Eyeworld Supplements

T he increasing number of post- refractive patients looking for pre- mium intraocular lenses has led my practice to shift completely away from multifocal platforms. That void has been filled in my practice by the enVista ® and TRULIGN ® toric intra- ocular lenses (Bausch + Lomb, Bridgewater, N.J.), which have become the first choices for nearly all of my IOL patients. Many of my patients want great intermediate vision to read their tablets or smartphones. This is the strength of the Crystalens ® IOL platform, on which the TRULIGN toric IOL is based. 8 I also have some patients with early macular changes, and multifocal IOLs are contraindicated for these patients. The enVista IOL, which I have used since it received U.S. Food and Drug Admin- istration (FDA) approval in 2012, is ideal for a wide range of patients. There are several unique features of this lens that I'll highlight below. Additionally, there are very few patients who could not benefit from the TRULIGN toric IOL, which I have implanted since 2013. I exclusively use this lens in post-refractive patients due to the multifocality of their cornea and because there is no need to worry about angle kappa. It does not induce any more halos or glare than their corneas may already have. 9 In my experience, the TRULIGN toric IOL really is a lens for a lifetime. As with most lenses, there are a few key steps that are important to ensure patient satisfaction and optimal outcomes, including the size and shape of the capsulotomy, the corneal health, postop regimens, communication, total un- derstanding, and preop counseling. The use of the premium platform—espe- cially the TRULIGN toric IOL—has certainly increased with the greater use of laser-assisted cataract surgery (LACS). Since incorporating a femtosecond laser into my practice I have increased my premium channel from about 25% to 80%. The monofocal platform with femto and astigmatic incisions is also becoming more important, especially with the enVista IOL. Premium vision series 2 Implanted Trulign Toric IOL centered on the axis Lenses with leading patient appeal by Dee Stephenson, MD continued on page 3 I think of this lens as a premium monofocal due to its pristine aspheric, aberration-free optic that provides patients great outcomes without compromising depth of field. 1,2 With all of the post-refractive patients needing cataract surgery, placing an aberra- tion-free aspheric optic in these patients is a must in my opinion. Bausch + Lomb is the only major IOL manufacturer to utilize this type of optic. Among the clinical considerations for the enVista IOL is its lack of glistenings, 3,6 the presence of which can make a difference in the quality of vision. A pristine optic that yields predictable outcomes irrespective of slight decentration or tilt is key. I work too hard on my outcomes and on refining my surgical technique to implant a lens that may have its own optical imperfections. To me it makes no sense to use anything less. In my practice, patients want to see well at night for driving. This makes a reduction in dysphotopsias important to them. Also, the increase in post-LASIK and RK patients who already have a multifocal cornea has increased the importance of not inducing any A well-centered pristine optic of the enVista

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