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Thursday / December 3.
Homeminews“First of its Kind”: Presbyopia Correcting IOL

“First of its Kind”: Presbyopia Correcting IOL

Alcon has launched the Acrysof IQ Vivity intraocular lens (IOL) at a virtual event hosted by television presenter Tracey Spicer.

Speaking at the event were ophthalmologists Dr Chandra Bala from Personal Eyes, Dr Michael Lawless from Vision Eye Institute, and Dr Paul McCartney from Hobart Day Surgery. Additionally, at the conclusion of the presentations, Drs Bala, Lawless and McCartney were joined by ophthalmologist Dr Angela Jennings (Personal Eyes), who spoke about her personal experience, having had the new IOL implanted.

Described as a “first of its kind” presbyopia correcting IOL, the Acrysof IQ Vivity features non-diffractive X-Wave technology which achieves a continuous range of vision for patients, while offering a monofocal-like visual disturbance profile.

It’s made my patients happier, my life easier and its offering an evolution

In essence, X-Wave technology means there are two smooth surface transition elements in the central 2.2mm of the IOL that work simultaneously to stretch and shift the wavefront of the lens. The first element, a slightly elevated smooth plateau (about 1μ in height) is responsible for stretching the focal range; the second element, a slight curvature change, shifts the continuous extended focal range to the anterior side of the retina, providing a full range of vision to the patient.

The result is an extended focal range with 6/6 at far; 6/7.5 at intermediate, and 6/9.5 at close distances.

Dr Chandra Bala reported on two large randomised masked control trials comparing bilateral implantation and six month follow up of the new AcrySof IQ Vivity IOL and its wellestablished monofocal cousin, the AcrySof IQ. Patients in both groups were implanted with IOLs with power ranging from 18.0 -25.0D and with astigmatism of less than 1D.

Dr Bala, who was the global coordinating investigator for the studies (one global and one in the United States), said Vivity was found to deliver superior intermediate and near vision while maintaining distance. Both lenses performed similarly with relatively stable visual acuity across pupil sizes at all distances.

Of study participants, 92% self-reported that the Vivity was a great lens with “good” performance for distance vision acuity; and 92% reported arms’ length vision was as good as it was for distance vision.

In terms of visual disturbance, performance on bench of the Vivity was very close to that of an Acrysof IQ. A new Quality of Visual Disturbance Questionnaire, designed by Alcon and validated by the Food and Drug Administration, found that 72% of Vivity patients were not bothered by starbursts. Indeed, there was no significant difference between the two IOLs when it came to glare, halos and starbursts.

Dr McCartney reported that he had been most impressed by patients’ ease of acceptance of the new IOL.

“They are almost unaware that they have it in… bench data shows there aren’t gaps in the focal range which… speaks to how my patients are so easily adapting to use this lens.”

Dr Bala said, “The AcrySof Vivity IOL delivers an extended range of vision – a functional visual range that goes from far to at least around 50cm.” He said, “Quality of vision for distance is good, contrast sensitivity for distance is good, it does not impair distance vision, but adds on top, a depth of vision from near to intermediate and all with aspheric monofocal visual disturbance. I think that’s what makes this lens a promising lens.”

Dr Michael Lawless agreed saying it offers, “Excellent visual quality with no unwanted symptoms – it’s a lens we’ve been wanting for some time… an exciting lens – one that you can place in all those patients in whom you would not want to put a PanOptix IOL – so that basically makes up the majority of patients.”

In the operating theatre, Dr Chandra Bala said the Vivity’s “familiarity is great, it’s easy to centre the lens, it is as close to inject and forget as you get. If it’s not perfectly centred, or centred enough, you’ll get loss of effect but no increase in photo phenomenon and no decrease in contrast sensitivity. It’s not a pupil dependent lens.”

At the time of presenting, Dr Lawless said he had implanted 112 Vivity IOLs since December 2019, and while judicious in how he has used it, Vivity had delivered on all promises.

Acknowledging the full range of IOLs now available he said, “It definitely expands the options” and “I have to think of why I wouldn’t use the Vivity lens… It’s made my patients happier, my life easier and its offering an evolution – we now have something in my hands that no other lens can do.”

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