Disclosure of finanacial interest * Author has no financial interest in this paper. ** Author's research is partially funded by Imperial Medical Technologies Cartersville GA, USA who produced, developed and supplied the product presented.

Slimming diet for a Multifocal IOL

Peculiarities of Models

Micro-Incision vs. Modified “C” G. Gallo M.D.*

G. Rubiolini M.D.** Italywww.grvision.com

The Micro-Incision Phaco procedure is widely becoming the “Standard” for Cataract surgery. This means ALL Multifocal IOLs “Diffractive” & “Refractive” must be injected with a <2.2mm Corneal Tunnel. Due to their “Optical Geometry” Diffractive lenses have dominated because Modified “C” lenses can have problems with cartridges of <2.75mm.

- PURPOSE -

Contd.

Can a new Refractive, “Progressive” Multifocal, Micro-Incision Plate style IOL using new “Optical Geometry” be implanted using a <2.2mm tunnel and be as successful as a Modified “C” IOL using a 2.75mm corneal tunnel ?

- MATERIALS AND METHODS -HP60CM – Hydrophilic Progressive – Multifocal Mod. “C” with “Refractive” optics.HP60CM – Hydrophilic Progressive – Multifocal Micro-Incision with “Refractive” optics. IOL CHARACTERISTICS

Mod “C” Optic: 6.00mmTotal Length: 12.00mmAC - Depth: 5.30mmA - Constant: 118.4Suggest Formula: SRK/T

Micro Plate: 6.00mmTotal Length: 11.00mmAC - Depth: 5.30mmA - Constant: 118.4Suggest Formula: SRK/T

PRESBIOPTICxTM by Imperial Medical, Cartersville, GA USA. The characteristic absence of lines is an IMT - Patent Pend.

THE IMT SOLUTION - NO LINES

EMPLOYING“THREE DIMENTIONAL CLOTHOID

CURVE” TECHNOLOGY

• Engineers reduced the thickness of the optic disc.• Eliminated areas for Halos & Glare.• Maintained the visual outcomes of the Mod “C” version. Patent Pend.

IMT’s Slimming Diet

PRESBIOPTICxMicro Incision

PRESBIOPTICx Modified “C”

- IMPLANT STRATEGY -• Progressive addition of multifocality with the customized option with the second IOL implant.• First lens Implanted – If emmetropia & near vision achieved the second lens is identical or…• First lens implanted – If near vision is not achieved the second lens can easily correct the problem.

-MODIFIED “C”- VS. -MICRO INCISION-

• 35 Patients - 20F &15M Avg. 56yrs.• Bilateral Progressive Multi-Focal IOL implants with a non-linear reading add from +3.6D to +4.5D (Progressive) during surgery.

• PRESBIOPTICx C-LOOP by IMT.

• Exclusion criteria included but not limited to astigmatism >1D, dia- betic retinopathy, maculopathy & previous ocular surgery.

•17 patients - 8F & 9M Avg. 52yrs. • Bilateral Progressive Multi-Focal IOL implants with a non-linear reading add from +3.6D to +4.0D (Progressive) during surgery.• PRESBIOPTICx Micro by IMT• Exclusion criteria included but not limited to astigmatism >1D, dia- betic retinopathy, maculopathy & previous ocular surgery.

-MODIFIED “C”- VS. -MICRO INCISION-• Total freedom from glasses 28

patients (>80%) w/ two similar near addition implants.• 5 patients received an extra 0.30D addition for the 2nd eye • Total – 33 (95%) achieved J2 best uncorrected near visual acuity with bilateral vision.• 100% of the patients achieved 20/25 or better uncorrected visual acuity for distance.• 2 Patients (60-90days) complained some temporary night vision problems such as glare, halos and sparkles (5,7%).

•Total freedom from glasses 15 patients (>88%) w/ two similar near addition implants.• 2 patients received an extra 0.20D addition for the 2nd eye. •Total – 17 (100%) achieved J2 best uncorrected near visual acuity with bilateral vision.•100% of the patients achieved 20/25 or better uncorrected visual acuity for distance.•2 Patients (30-60days) complained some temporary night vision problems such as glare, halos and sparkles (11,7%).

18,5D 19D 20D 20,5D 21 D 21,5D 22D 23D 23,5D 24D 25DIOLs Diopters Implanted

RESULTS MODIFIED “C” MICRO INCISION >2.75mm CORNEAL TUNNEL <2.2mm Excellent NEAR VISUAL ACUITY Excellent

Excellent DISTANT VISUAL ACUITY Excellent

5.7% 75days TEMPORARY HALOS & GLARE 11.7% 45 days

- CONCLUSION -• The Micro-Incision version (HP60PM) of the IMT HP60CM, “Progressive” Refractive Multifocal IOL provides an excellent visual acuity for distance & near and it can be customized in the 2nd eye to achieve a full range of vision.

• Full range of vision can be achieved in 100% of the cases .• <2,2mm corneal tunnel can be successfully used for this IOL due to a slimming diet from the original Mod-C version IOL.

Thank You

2.75mm 1.9mm Modified-C Micro Incision