Intraocular lens

But honestly, to a lot of these folks, it doesn't matter, especially if they're going for a premium lens.

Now, the differential isn't that huge between self-pay and going for whatever they want in terms of a premium IOL.

Now, in your limited study that you did through your practice, tell us what were the kind of important findings? Well, it

mirrored pretty closely.

Mind you, I'm not a glaucoma guy, but you know when I taught my residents at County Hospital? Oh, no, for sure.

It's kind of like South Africa.

So I'd have patients come in with NVG, neovascular glaucoma, and we'd do Dave Aston, and then the same night, we'd take them to the operating room, take out their cataract, put on the indirect ophthalmoscope, shoot down 2,000 spots of PRP, put the IOL in, and put the ombalve in in one

sitting.

Yeah, so every academy for at least the last three or four years, there's been a lot of talks on IOL fixation techniques.

And I'll tell you, you know, when we look at it, still Gore-Tex sutured IOLs, that's the four-point fixation IOLs, and the Yamani IOLs are kind of the two most popular techniques.

We talked to Frank Brody about his device that looks amazing for the, you know, dislocated eye wells capsular bag compromise and whatnot but there's a really nice section it's how do i do it it's on saturday at 3 45 and 3 52. omesh gupta is going to be talking about gore-tex scleral fixated iol techniques and then for the show mu autumn is going to be talking about yamani technique iol placement And it's going to be great to be able to hear these two talks on their particular tips and techniques and how they've refined these surgeries over the years.

Mu was on our show talking about IV-less surgery.

So if you missed that episode, go back and take a listen.

Part one of our two-part ESCRS coverage begins with Alcon, which launched its Clarion Panoptix Pro trifocal IOL and Clarion TruePlus monofocal IOL in Europe.

To learn more about the IOLs and their characteristics, we spoke with Semba Leone, President Surgical at Alcona International.

Super excited to be here in London where we're introducing a number of new technologies.

Today I'd like to highlight a couple of launches that we're making in the IOL space, one being Clarion Panoptix Pro.

It's 100% Swiss-made, manufactured in our facilities and CE-approved.

Together with UNIQA we are launching EPIC.

EPIC is a femtosecond laser utility for the bladeless implantation of fake IOLs.

EPIC fits perfectly to premium offerings.

But, but now we're trying to hold, you know, community optometry, uh, sessions where we invite our local community optometrists to learn about what the clinic's doing, and it's often a mix of, I suppose, introducing them to the type of technologies that we're using, the type of patients that the technology's suitable for.

'Cause Arthur, who's the medical director of the, of the clinic, is a world leader in a lot of these spheres, including keratoconus and ICL and LASIK.

So- Uh, we're always trying to be at the cutting edge of the technology

Push boundaries

I mean, it, the start of all of our consultations and even the patient information that they receive, we'll explain to them how their eye is gonna change over their lifetime.

Because I think if you're gonna make a decision to have surgery on your eye, it's imperative that you understand what the impacts of that decision are long term.

So if I meet a 20-year-old who is, you know, minus five and they wanna get out of glasses, or even minus two maybe, to make it more difficult, um, I would explain to them from the get-go, if you have laser refractive surgery or if you have ICL surgery now to correct your distance vision, because of the fact that your lens is flexible, you will be out of glasses until your mid-40s, but then you'll need reading glasses.

It's really important they know that, 'cause there's this, you know, this LASIK wore off and all this kind of...

So basically, in summarizing, when you are following all these anterior hyaloid phase friendly maneuvers, Whenever in a case of PCR or a pre-existing defect, you can still save your case.

You can still continue FACO and put your IOL in the bag or in the sulcus.

So that is the whole thing.

What I thought was so innovative is that normally we think, the old way of thinking is the capsule broke the vintage pro lab but you said no no there are two separate events the first thing and then breaking the anti-halid face of the just pull up to the second event So if you just have the break of the capsule and you see it fluttering back and forth, that's telling you that the actual antiretroviral phase is still intact and you can still see the case.

And then you lower down your parameters.

And then you phacomulsify the central core.

And then you can use an IOL scaffold, like put an IOL underneath.

So these two things we especially use in harder cataracts, more gagging cataracts, where the PC is very floppy.

And it's usually pretty low stress for the patients.

Now, you mentioned that, of course, there's the IOL, which is the lens implant.

And there's a couple of different lenses available now that patients, in fact, have a say of what type of lens gets put in.

Because I think a lot of people don't know that with these implants, they can accommodate for some level of what they had previously had in their glasses prescription.

Perfect.

And then, you know, we could, we'll leave who's going to be a candidate for that for the discussion.

If somebody's going in for surgery, they can have that discussion with their surgeon because if somebody's got a really minor amount, they may not suggest an implant to TORIC IOL versus if somebody has a whole lot, they may have to consider a few different factors.

But the other lenses that may come up in that discussion include ones that you mentioned, the EDOF or EDOF lenses, and also the light adjustable lens or LALs.

Yes, and a specific focus on complexity would help alleviate a lot of this.

And it's interesting in our data, we actually showed that the more complex cases, the complex RDs, the 67113 code, IOL exchanges, 66986 code, those types of cases suffered the most from a financial efficiency standpoint for these centers.

98 to 99% less efficient per minute.

And again, that's not a reflection on a surgeon's efficiency.

But at that time, what, what really moved me, um, I, I think to complement our clinical practice, we need, uh, also to, to get together with some research and some, uh, educational field.

So everything complements our clinical activity, right? So at that time, I was really, really puzzled with the, the IOL power calculation and the guides, you know.

And yeah, so I thought physics can explain, uh, all of this.

We, we don't see any kind of manufacturer of a, I don't know, telescopic, uh, lenses doing formulas to, to achieve the best results.

The pupil, everything.

The, the, the sensitivity of different, uh, frequencies, for instance.

So ev- e- all this stuff we can simulate if we have a proper, uh, pseudophakic eye model that allowed us, of course, knowing the exact, uh, parameters of the IOL, which is kind of difficult.

As you know, the manufacturers don't, don't release this information.