EYEDIFF PLUS +3.50D Diffractive Multifocal IOL “A New Alternative” Prof. Dr. Daniel H. Scorsetti University of the Salvador - Catholic Pontificia University

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EYEDIFF PLUS +3.50DEYEDIFF PLUS +3.50DDiffractive Multifocal IOLDiffractive Multifocal IOL

““A New Alternative”A New Alternative”

Prof. Dr. Daniel H. ScorsettiUniversity of the Salvador - Catholic Pontificia University of Argentina

Faculty of Medicine - Faculty of Medical SciencesChair of OphthalmologyBuenos Aires, Argentina

Eyediff Plus +3.50D: Eyediff Plus +3.50D: Technical SpecificationsTechnical Specifications

Diffractive Technology

Perfect Light Distribution for Distance &Near( 60/40)

Addresses Cataract Patients with or without Presbyopia

Allowed Patients a High Level of Freedom From Glasses in

clinical trial

EYEEYEDIFF Plus Presbyopic IOLDIFF Plus Presbyopic IOL

Advantages Provides multifocal vision Reduced pupil dependency Balanced distribution of light Able to tolerate some decentration

Full Optic Regular Diffractive IOLFull Optic Regular Diffractive IOL

Advantages Provides multifocal vision Reduced pupil dependency Balanced distribution of light Able to tolerate some decentration

* Creates Halos and scattering Light

Disadvantages Potential for Scattering of light

and glare and halos at nightbut

Full Optic Diffractive IOLFull Optic Diffractive IOL


ZonesZones

EYEDIFF Plus - Predictable refractive outcome EYEDIFF Plus - Predictable refractive outcome

+3.00D Addition


+3.50D Addition


+4.00D Addition

Show OpticShow Optic

Far

Near

Intermediate

EYEDIFF PLUS – Predictable Customized LIOEYEDIFF PLUS – Predictable Customized LIO

EYEDIFF PLUS - Predictable refractive outcome EYEDIFF PLUS - Predictable refractive outcome Analysis of the mistake : Analysis of the mistake : Square root of the sum of the squaresSquare root of the sum of the squares

Warren E. Hill, MD, FACSWarren E. Hill, MD, FACS

EYEDIFF PLUS - Predictable refractive outcome EYEDIFF PLUS - Predictable refractive outcome Analysis of the mistake : Analysis of the mistake : Square root of the sum of the squaresSquare root of the sum of the squares

Warren E. Hill, MD, FACSWarren E. Hill, MD, FACS

Aspheric Optic (Aberration Neutral)Aspheric Optic (Aberration Neutral)

360° Square Edge360° Square Edge

Edge thickness correspond to

standard designed IOLs

Square edge design

Perfect centration in the capsular bag

Perfect optical performance

Extremely low incidence of PCO

Anti Z effect Haptic design

EYEDIFFEYEDIFF Plus 360⁰Square Edge Plus 360⁰Square Edge

Careful Keratometry1.0D corneal power error affects 1.3 to 1.6D IOL

power calculation Careful Axial Length

1.0mmAL error affects the post-operative refraction by 1.2 to 2.5D aprox.

IOL Master: SRK II--------- 118.6 SRK T-------- 118.4 Holladay 1 - sf--- 1.37 Haigis ----- a0=0.95, a1=0.4, a2=0.10 Hofer - pACD-- 5.17

Aim Emmetropia & Astigmatism <1.0D A-Const. & ACD ( Surgeon Factors)

IOL Power calculationIOL Power calculation

Objective: to compare the visual quality preop and postop., between 2 multifocal IOLs and 1 monofocal

Material and methods : 60 eyes of 30 pts. divided into 3 groups, informed and signed assent, cataract degrees II and III, older than 55 years (average 60 years), without ocular disease or astigmatism > 1.0D. Bilateral implants, the same IOL in every patient (not mix and match)

Equipment: Alcon InfinityTechnique : Facotorsional with Ozil IP, 2.2mm (intrepid)Incision in the steepest axis and the same protocol in all cases

• Group 1: 10 pts. Acrysoft IQ• Group 2: 10 pts. Acrysoft Restor• Group 3: 10 pts. EYEDIFF PLUS +3.5D

Clinical TrialClinical Trial

Preop Complete ocular exam:• UCVA & BCVA: far, intermediate (70 cm) and near (40 cm)• Pentacam HR• IOL Master• Contrast Sensibility : photopic and mesopic• NEI VFQ-25 Questionnaire with Apéndix NEI VFQ-39 (in Spanish)

6 questions to evaluate visual general health20 questions to evaluate difficulties in visual activities 13 questions to evaluate level of acceptance of visual loss


NEI VFQ: National Eye Institute, Visual Function Questionnaire

Postop complete examination : days 1 - 7- 30 - 90

• UCVA & BCVA: far, intermediate (70 cm) and near (40 cm)• Pentacam HR• Contrast Sensibility : photopic and mesopic• NEI VFQ-25 Questionnaire with Apéndix NEI VFQ-39 (in Spanish)

6 questions to evaluate visual general health20 questions to evaluate difficulties in visual activities13 questions to evaluate level of acceptance of visual loss

• Follow-up 3 months


Questionnaire • Group 2 and 3: better in postop. to read newspaper and close

vision activities. • Group 3: less difficulty in night driving, But without statistically

significant difference with 2. • Group1: statistical significant difference to favor to drive by night

Without intraop complications Without PCO Descentrations

• 2 minor in group 2• 1 minor in group 3

Halos/Glare• 3 tolerable in group 2• 2 tolerable in group 3

Results Results

UCVA BCVA

0.17

0.58

0.750.89

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

0.51

0.790.95 1

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

Results FAR – GROUP 1: Acrysoft IQResults FAR – GROUP 1: Acrysoft IQ

UCVA BCVA

0.18

0.65

0.810.91

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

0.55

0.71

0.93 1

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

Results FAR – GROUP 2: Acrysoft RestorResults FAR – GROUP 2: Acrysoft Restor

Results FAR – GROUP 3: EYEDIFF PLUSResults FAR – GROUP 3: EYEDIFF PLUS

UCVA BCVA

0.23

0.71

0.91 0.94

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

0.42

0.76

0.99 1

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

UCVA BCVA

0.28

0.79

0.93 0.95

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

0.51

0.92 1 1

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

Results NEAR – GROUP 2: Acrysoft RestorResults NEAR – GROUP 2: Acrysoft Restor

AV S/C AV C/C

0.32

0.73

0.830.96

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

0.62

0.89 0.95 1

00.10.20.30.40.50.60.70.80.9

11.1

Preop 1 WeekPO.

1 MonthPO.

3Months

PO.

Results NEAR – GROUP 3: EYEDIFF PLUSResults NEAR – GROUP 3: EYEDIFF PLUS

Intermediate Vision (70 cm)Intermediate Vision (70 cm)

GROUP 2Acrysof Restor DECIMAL DISTANCE

INTERMEDIATE WITHOUT CORRECTION 0.4 70 cm

INTERMEDIATE WITH CORRECTION 1.0 70 cm

GROUP 3 – EYEDIFF PLUS DECIMAL DISTANCE

INTERMEDIATE WITHOUT CORRECTION 0.5 70 cm

INTERMEDIATE WITH CORRECTION 1.0 70 cm

EYEDIFFEYEDIFF Plus Plus

EYEDIFFEYEDIFF Plus Plus

ConclusionsConclusions Less adverse effectsLess adverse effects

Good results post-surgeryGood results post-surgery

Individual map wIndividual map with MTF and topography of ith MTF and topography of

IOL powerIOL power

Variety of powers for nearVariety of powers for near

First Customized IOL First Customized IOL

Cost

Thank you very much!!!Thank you very much!!!

[email protected]@arnet.com.ar

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EYEDIFF PLUS +3.50D Diffractive Multifocal IOL “A New Alternative” Prof. Dr. Daniel H. Scorsetti University of the Salvador - Catholic Pontificia University