IOL Terminology

There is a need to provide greater clarity for the terminology used to describe many of new-generation IOLs. Dermot McGrath reports.

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A new rotationally asymmetrical multifocal IOL with +1.5 D near addition provides patients with excellent distance and intermediate visual acuity, with high contrast sensitivity and a low number of photic side-effects, according to Florian Kretz MD, FEBO. Discussing the properties of the Lentis Comfort (Teleon GmbH, Berlin, Germany) lens at the 25th Winter Meeting of the ESCRS, Dr Kretz, medical director of the Precise Vision Augenärzte in multiple locations in Germany, said that the concept of the IOL is to offer an enhanced depth of focus with enhanced near and intermediate vision at a range up to 60 cm. “We have evaluated the Comfort for a long time and have found that it offers several advantages over a lot of other competing IOLs. It shows similar-to-less incidence of dysphotopic phenomena compared to an aberration-neutral monofocal lens such as CT Asphina 409 IOL (Carl Zeiss Meditec). The rotational asymmetric optics also demonstrate better near-intermediate values compared to mini EDoF IOLs as they are less pupil dependent,” he said. In comparison simulation studies with the Eyehance (Johnson & Johnson Vision) monofocal EDoF IOL, the Comfort lens offered a better overall defocus capacity because of the higher add power, with closer usable intermediate vision, less pupil dependence and very low photic side-effects, he said. The Comfort also compares favourably with the new Vivity lens (Alcon), which uses wavefront-shaping design to provide a continuous range of focus with minimal halos and glare. “If we compare it to the Comfort data in the recent trial conducted by Dr Oshika (Oshika, T. et al, Sci Rep 9, 13117 (2019)), the Comfort lens gives even more stable outcomes for intermediate distance and is also less pupil-dependent because it is rotationally asymmetric,” he said. In a panel discussion after his presentation, Dr Kretz remarked on the need to provide greater clarity in terms of the terminology used to describe many of these new-generation IOLs. “It is very confusing. I personally don’t like this nomenclature with ‘monofocal plus’, ‘mini EDoF’ and so forth, which doesn’t tell us anything about the lens. I think the physical properties of the IOL are much more important. This is a rotational asymmetric lens with +1.5 D add, which gives enhanced vision in a range up to about 60 cm and more if the patient has higher spherical aberration on the cornea and less if the cornea is more neutral,” he said.
Tags: cataract and refractive