A monofocal intraocular lens (IOL), that offers both distance and intermediate vision without glare and haloes, has been launched by Johnson & Johnson Vision (J&JV).
The Tecnis Eyhance Monofocal IOL was launched at the Orion conference for ophthalmologists in Sydney in late June, with presentations by a number of surgeons who have implanted the lens in Australia, Europe and New Zealand.
Despite being referred to as a next generation monofocal IOL by J&JV, the surgeons mivision spoke to post the conference were insistent that the Tecnis Eyhance is more of an extended depth of focus IOL.
this is not a monofocal but falls more closely into the category of an EDOF IOL without any of the possible compromises
“It is important to understand that this is not a monofocal but falls more closely into the category of an EDOF IOL without any of the possible compromises the latter may cause in regard to night time visual disturbance such as haloes and starbursts,” said Dr Dean Corbett from Auckland Eye in New Zealand.
Dr Andrew Atkins from Victorian Eye Surgeons echoed his sentiment. “The Tecnis Eyhance intraocular lens is an EDOF IOL that promises to provide distance and intermediate vision without the previously noted side effects of glare and haloes that have been associated with these IOLs”.
According to results from clinical trials, as well as surgeon and patient feedback, patients who have had the Tecnis Eyhance IOL implanted have been able to enjoy activities dependent on intermediate vision, such as crafts, shopping, work around the home and playing sport such as golf. Additionally, they have been able to walk with more confidence on uneven surfaces and on stairs.
Critically Different Design
To the naked eye, the design of the Tecnis Eyhance IOL is indistinguishable from the Tecnis Monofocal lens ZCB00 yet in reality, J&JV states that it is critically different.
The Tecnis Eyhance features “a continuous change in power from the periphery to the centre of the lens, creating a unique anterior surface that improves intermediate vision, maintains distance image quality comparable to aspheric monofocal IOLs, delivers a profile of photic phenomena similar to the ZCB00, and keeps on reducing spherical aberration to near zero”.1
Dr Atkins, who has now implanted 20 Tecnis Eyhance IOLs, presented his findings to the Orion conference. He said his experience had been “very satisfactory”, that the procedure was no different from routine cataract surgery, and the intraocular lenses are straightforward to load and insert.
“The follow-up period has only been an average of one week, so it is early and we don’t have enough data. But at the post-op visits so far, 91% had uncorrected distance visual acuity of 6/9 or better, including 27% at 6/5. Patients, when tested, had demonstrably better intermediate vision than the contralateral eye, which had a single vision distance monofocal intraocular lens implant.”
Dr Atkins noted that the “reduction in glare/haloes is a very enticing benefit as we see a lot of country patients in our practice and these are people that drive a lot, often at night time”.
He reiterated that, “more follow up time is definitely needed”.
Dr Corbett also presented his findings, having implanted the Tecnis Eyhance ten times. He said when compared against standard aspheric monofocal IOLs, the Tecnis Eyhance offered improved outcomes that “relate to a greater range of vision and likelihood of achieving clear vision for distance without glasses”.
As well as improving driver safety and patients’ ability to manage day to day intermediate tasks, he said, “they are also more able to enjoy personal interactions because they can clearly see at communication distances.
“These IOL’s may result in a decrease on spectacle dependence, but it is expected that patients will still need reading glasses in most cases,” said Dr Corbett.
A Replacement for Monovision IOLs
Dr Francesco Carones from Italy said the Tecnis Eyhance could replace a surgeon’s consignment of monofocal IOLs. He described the Tecnis Eyhance as providing “quite significant difference” in patient vision, and gave the example of a patient fitted with a monofocal IOL in her first eye and the Tecnis Eyhance in her second. He said post the Eyhance implant, “she is using her spectacles 50% less of the time now… it’s not just for computer distance, it’s more for common life… when going to the grocery store, they can see prices on the shelf, and they can pick up a phone and see a message.”
“Bilateral implants will return your patient to 50–55 years vision, when they needed spectacles for reading but not for everything,” he said.
On consulting patients, Dr Carones advised, “You don’t want to speak to them about spectacle independence or correcting presbyopia, you want to tell them they will get functional vision mostly at intermediate, and at near if the light conditions are good, so there will be less need to have their spectacles with them all the time.”
For the small difference in price for the Tecnis Eyhance vs a traditional monofocal, Dr Dr Carones said Eyhance was “definitely worth it”.
“I would definitely choose a Tecnis Eyhance IOL instead of a traditional monofocal… This lens can replace your consignment of monofocal IOLs… in terms of safety it can be implanted in any eye without any concerns. I am looking forward to having the toric version because that is currently the only limitation.
- Delivering Intermediate Vision: the New Tecnis Eyhance Monofocal IOL. Highlights from the Frankfurt January 2019 Advisory Board Meeting. Johnson & Johnson Vision.