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size of the original corneal incision. The addition of the ReSTOR +2.5 D with ACTIVEFOCUS Optical Design will help surgeons customize the multifocal IOL options they can offer their patients to maximize results and better manage patient expecta- tions. It really is a multifo- cal/monofocal hybrid de- sign, combining the best of the technology behind the AcrySof IQ monofocal IOLs with the visual range of the ReSTOR multifocal lens. Reference 1. Nuijts RM, et al. Bilateral im- plantation of a +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes. J Cataract Refract Surg. 2016;42:194–202. eye and the +3.0 in the non-dominant eye. The interesting observation that most patients have is their ability to see better at distance with a +2.5 lens than with a 3.0 lens. The two eyes work together well for near, intermediate, and distance vision. I have been very happy with that as an alternative. In summary, UltraSert represents the newest entry in single-use IOL delivery systems and com- bines the control of a man- ually loaded device with a disposable preloaded injector. The system uses the TensionGlide plunger, designed for controlled delivery of the IOL into the capsular bag, and the depth guard nozzle, which is designed to preserve the Dr. Lane: Let's talk about the combination of a +3.0 and a +2.5 compared to a +2.5 bilateral. A recently published article discussed European experience that compared bilateral +2.5 implantation to a +3.0 and a +2.5 implantation. 1 Not unexpectedly, it showed that contralateral implan- tation of +2.5 and +3.0 has as sharp distance vision as bilateral +2.5, along with a nice range for intermediate vision. Suprisingly, near vision between the 2 arms was different, and mean BCVA showed a marked difference between the contralateral and bilateral groups. For people who want it all, that's what I routinely do and have had good success. For whatever reason, I usually implant the +2.5 in the dominant of defocus is very minimal from plano to –0.50 spheri- cal equivalent (SE). In con- trast, with the +3.0, at –0.50 SE, distance acuity signifi- cantly suffers. With a mono- focal, however, if the pa- tient is plano to –0.50 SE, he or she is still quite happy. With the +3.0, that patient is not very happy. Dr. Lane: Have you changed your IOL choices with the introduction of ReSTOR +2.5 with ACTIVEFOCUS Optical Design? Dr. Cibik: Since the FDA approved the +2.5 with ACTIVEFOCUS, it is now my presbyopia IOL of choice. I find the outcomes with ReSTOR +2.5 are much more reproducible and consistent. Important product information UltraSert™ Pre-loaded IOL Delivery System with the AcrySof® IQ aspheric IOL Model # AU00T0 US-ULS-15-E-0452 Caution: Federal (USA) law restricts this device to the sale by or on the order of a physician. Indications: The AcrySof® IQ aspheric intraocular lens ("AcrySof IQ") is intended for the replacement of the human lens to achieve visual correction of aphakia in adult patients following cataract surgery. This lens is intended for placement in the capsular bag. Warning/precaution: Use the UltraSert™ Pre-loaded Delivery System ("UltraSert") at temperatures between 18 degrees C (64 degrees F) and 23 degrees C (73 degrees F). Use only Alcon viscoelastic qualified for this device. Do not use the UltraSert if the nozzle appears damaged or deformed. Follow the Directions for Use for correct order and sequence of steps to avoid damage to the IOL or the UltraSert. Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use. Caution should be used prior to lens encapsulation to avoid lens decentrations or dislocations. Studies have shown that color vision discrimina- tion is not adversely affected in individuals with the AcrySof® Natural IOL and normal color vision. The effect on vision of the AcrySof® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45 degrees C. Attention: Reference the Directions for Use for Model AU00T0 for a complete listing of indica- tions, warnings and precautions. AcrySof® IQ ReSTOR® Family of IOLs Caution: Federal (USA) law restricts this device to the sale by or on the order of a physician. Indications: The AcrySof® IQ ReSTOR® Posterior Chamber Intraocular Lens (IOL) is intended for primary implantation for the visual correction of aphakia secondary to removal of a cataractous lens in adult patients with and without presby- opia, who desire near, intermediate, and distance vision with increased spectacle independence. The lens is intended to be placed in the capsular bag. Warnings/precautions: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ra- tio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Physicians should target emmetro- pia, and ensure that IOL centration is achieved. Care should be taken to remove viscoelastic from the eye at the close of surgery. Some patients may experience visual disturbances and/or discomfort due to multifocality, especially under dim light conditions. As with other mul- tifocal IOLs, visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. Spectacle independence rates vary with all multifocal IOLs; as such, some patients may need glasses when reading small print or looking at small objects. Clinical studies with the AcrySof® ReSTOR® lens indicated that posterior capsule opacification (PCO), when present, developed earlier into clin- ically significant PCO. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon for this product informing them of possible risks and benefits associated with the AcrySof® IQ ReSTOR® IOLs. Studies have shown that color vision discrimina- tion is not adversely affected in individuals with the AcrySof® Natural IOL and normal color vision. The effect on vision of the AcrySof® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45 degrees C; use only sterile irrigating solutions such as BSS® or BSS PLUS® Sterile Intraocular Irrigating Solutions. Attention: Reference the Directions for Use labeling for a complete listing of indications, warnings and precautions. 4/16 US-ULS-16-E-1637 Innovative IOL technologies for the cataract surgeon

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