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Innovative Technologies Designed to Meet the Needs of Surgeons and their Patients excited about that option because of the exceptional stability with the AcrySof IQ Toric platform. Dr. Hammond: The most important thing is track- ing your outcomes, so you know when you put a lens in that you will get the result you expect. It is the same technique as any oth- er monofocal lens—while the ACTIVEFOCUS optic is very forgiving, it does need to be aligned with the opti- cal axis. Discuss the hybrid monofocal/multifocal design of the lens. Dr. Hammond: With a typi- cal multifocal IOL, a certain percentage of the lens is dedicated to distance vision and a certain percentage of the lens is dedicated to near vision. The nice thing about the ACTIVEFOCUS design is that the very cen- tral part of the multifocal is 100% dedicated to distance vision. So, it acts similarly to a monofocal as far as the very central aspect of the lens goes, meaning that it provides really nice, crystal clear, distance vision. The unique ACTIVEFOCUS opti- cal was designed specifical- ly to minimize visual distur- bances like halo and glare that have been so highly reported in the past with multifocal IOLs. Dr. Weaver: It's a multifo- cal, but the center part acts like a monofocal. That's the hybrid designed lens. The outside of the lens has 7 diffractive rings to provide intermediate and near vi- sion. It has fewer rings than the ReSTOR 3.0 D, so I have not had any patients who have reported significant haloing in their vision. It's a very forgiving implant from that standpoint. Dr. Scoper: This aspect of the lens has really made a big difference. When the ACTIVEFOCUS design launched, I thought it was just another model of the ReSTOR multifocal or just another low-add lens. I have learned that it is not just another multifocal, because the central portion of the lens is 100% dedi- cated to distance. I would describe it as a hybrid lens and not just another low power. The central portion is dedicated to 100% dis- tance vision—my patients report wonderful uncor- rected distance vision. That has been a game-changer for me, and I have been implanting this lens with confidence that I'm provid- ing patients with uncom- promised distance vision. With all of the other multi- focals that I have implant- ed, the central portion is a blend for intermediate vision, so patients see well at distance, but they don't see as well at distance as with ACTIVEFOCUS. It is very similar to a monofocal lens when it comes to the quali- ty of distance vision. What has been your patients' response to the ACTIVEFOCUS optic? Dr. Weaver: "Wow!" is a routine response, because patients have such sharp distance vision. It has be- come my go-to implant in terms of today's patients, who are very different from the patients we've seen before. Today's patients have greater expectations and with the ACTIVEFOCUS design I'm able to deliver on those expectations. Dr. Hammond: It's been great! This is my favorite lens so far because the patients are so happy. If I have been able to appropri- ately set the expectations, deal with astigmatism, and hit my target, these are the happiest patients I've ever had. Before ReSTOR +2.5 with ACTIVEFOCUS, I have never had a multifocal lens 20/15 distance vision pa- tient. Many of my patients who are 20/15 at distance can read the computer very easily without glasses. What is your approach for implanting the AcrySof IQ ReSTOR +2.5 D with ACTIVEFOCUS? Do you have any pearls? Dr. Scoper: It is very straightforward to implant, just like any of the other multifocals. I want a good, consistent capsulorhexis, and I want the lens to be well-centered on the light reflex of the operating mi- croscope. With the AcrySof material, it's sticky to the capsule, so once I put that lens in and have it well-cen- tered, I tap it down so it is sticking to the posterior capsule and there can be no viscoelastic behind it. Once this is done, that lens just doesn't move. It doesn't slip and slide around like some other materials. We abso- lutely must correct even low levels of corneal astigma- tism (1.0 D and less) with a multifocal IOL, and I do this with gimbal relaxing inci- sions (LRIs) with a femtosec- ond laser very successfully. If we can't correct all of the astigmatism with the LRIs, I will definitely wait until AC- TIVEFOCUS toric is commer- cially available. I am very continued from page 5 ACTIVEFOCUS ™ : Optical design 1 Central portion 100% dedicated to distance Optimized to offer your patients monofocal-like distance vision Contrast sensitivity comparable to the AcrySof IQ IOL 7-step apodized diffractive design for more efficient light management • Further decreases visual disturbances • Provides an extended range of vision • +2 D add power at the spectacle plane (when targeting plano)

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