1. Fernando Llovet, MD, PhD. Contributing Authors: Margarita Cabanás, MD; Jaime Beltrán, MD; Julio Ortega-Usobiaga, MD; Clara Martín- Reyes, MD; Victoria De Rojas, MD, PhD; Julio Baviera, MD Two Years clinical study of Diffractive Multifocal Acritec 366 IOL implantation in 530 eyes Non Financial Interest

2. Purpose To report on postoperative safety and efficacy outcomes with the diffractive Acritec 366D implantation after cataract or clear lens surgery. Setting: Clínica Baviera, Instituto Oftalmológico Europeo, Spain Non Financial Interest

3. CLÍNICA BAVIERA. Instituto Oftalmológico Europeo Material & Method Bilateral phacomeulsification between 06/06 - 03/08 (six months min. follow up) 30 eyes of 265 patients, 101 males and 164 females, Age from 45,6 to 64,4 Diagnosis of cataract in 280 eyes, myopic clear lens in 14 eyes and hyperopic clear lens in 236 eyes. Diffractive Acritec 366D were implanted in all eyes. Safety, efficacy, predictability and complications were analyzed. Non Financial Interest

4. CLÍNICA BAVIERA. Instituto Oftalmológico Europeo FEMALE55 ± 9.3 (35,78) 55 ± 9.4 (34,78) MEN56 ± 9.6 (34,77) DISTRIBUTION BY GENDER (n patients) MEN101 FEMALE164 DISTRIBUTION BY AGE Non Financial Interest

5. CLÍNICA BAVIERA. Instituto Oftalmológico Europeo MYOPIC CL HYPEROPIC CL 280 14 236 DISTRIBUTION ACCORDING TO DIAGNOSIS CATARACT Non Financial Interest

6. CLÍNICA BAVIERA. Instituto Oftalmológico Europeo SPHERECILINDEREESPHERECILINDEREE AVERAGE -3,39-0,98 -3,88 3,64-0,89 3,19 SD2,720,812,722,240,952,20 MAX-0,250-0,512,5011,87 MIN-12-4-12,750-5,75-2,87 HYPEROPIA (n = 458) REFRACTIVE DISTRIBUTION (n = 530) MYOPIA (n = 72) Non Financial Interest

7. Results The mean far uncorrected visual acuity (UCVA) was 0,81 monocular and 0,94 binocular; mean near UCVA J3 monocular and J2,5 binocular; mean intermediate binocular UCVA J6,13. Intraoperative complications: zonular dialysis with vitreous loss in one eye, iris dehiscence in one eye. Postoperative complications: Macular cystoid edema 1 eye, run out 1 eye and 78 posterior capsular opacification (PCO) with YAG capsulotomy were described. Global efficacy index 0,94, cataracts group 1, clear lens group 0,91. Global safety index 1,10 cataract group 1,15 and clear lens group 1,06. Non Financial Interest

8. FV monoc FV binocNV monoc NV binocMV binoc FV monoc FV binocNV monoc NV binocMV binoc FV monocFV binoc FV monocFV binoc Visual Acuity Non Financial Interest AVERAGE Preop BSCVA Postop UCVA Postop UCVA Preop BSCVA Postop UCVA Postop UCVA

9. Near UCVA Non Financial Interest

10. CLÍNICA BAVIERA. Instituto Oftalmológico Europeo 1 1 1 1 78 62(Yag ) PCO POST-SURGICAL COMPLICATIONS CYSTOID MACULAR EDEMA ZONULAR DESINSERTION WITH VITREOUS LOSS INTRASURGICAL COMPLICATIONS RELOCATION IRIS MINIMAL DESINSERTION Non Financial Interest

11. Conclusions This study shows Difractive Multifocal Acritec implantation to be a safety and effective method of refractive surgery in cataracts and myopic or hyperopic clear lens. However longer follow up is considered necessary. Non Financial Interest

12. THANK YOU CLÍNICA BAVIERA. Instituto Oftalmológico Europeo. Non Financial Interest