1. Robert G. Martin, MD Donald R. Sanders, MD, PhD Following Implantation of 4 Foldable Lens Designs Higher Order Aberration Higher Order Aberration

2. Study Objective Objective Of The Study Was To Determine If Implantation Of Different Foldable Lens Designs Resulted In Different Amounts Of Higher Order Aberrations

3. Study Design Patients Had Tracey VFA Performed On Eyes To Undergo Cataract Extraction Patients Were Randomly Assigned To Receive 1 Of 4 Foldable Lens Designs Tracey VFA Was Repeated At 1 Week Postoperatively Patients Had Tracey VFA Performed On Eyes To Undergo Cataract Extraction Patients Were Randomly Assigned To Receive 1 Of 4 Foldable Lens Designs Tracey VFA Was Repeated At 1 Week Postoperatively

4. Pupil Size All pre and postoperative measurements of higher order aberrations were done with a 4.5mm pupil size

5. Foldable Lens Designs STAAR Collamer STAAR Plate Haptic Silicone ALCON SA-60 AMO Sensar STAAR Collamer STAAR Plate Haptic Silicone ALCON SA-60 AMO Sensar

6. Preoperative Total Higher Order (HO) Aberrations No Significant Difference Between IOLs

7. One-Week Postoperative Total Higher Order (HO) Aberrations Collamer significantly better than STAAR plate and Alcon SA-60 (p< 0.005) N = 21N = 24N = 19N = 16

8. Collamer IOL Collamer Had Significantly Less HO Aberrations Than STAAR Plate And SA- 60 (P 0.005). Difference With Sensar Was Not Significant. Collamer Had Significantly Less HO Aberrations Than STAAR Plate And SA- 60 (P 0.005). Difference With Sensar Was Not Significant.

9. Note Sample size may be too small, especially with the Sensar group, and results could change with a larger sample. However, we have strong clinical indications that less higher order aberrations are induced with the Collamer lens as compared to plate lenses and AMO lenses.

10. Pre-op – Average H.O. Aberrations STAAR Collamer Alcon SA-60 STAAR Plate AMO Sensar

11. Postop – Average H.O. Aberrations STAAR Collamer Alcon SA-60 STAAR Plate AMO Sensar

12. Summary Three Other Foldable Lenses Tested Had Between 55% and 117% More Higher Order Aberrations at 1 Week Postoperatively than the STAAR Collamer IOL

13. This Is A Study Of Optical Aberrations Is it clinically significant? Is this especially significant in patients with large pupils? Do we need a bigger implant? Do we need a different shaped lens? Do we need a different edge? Do we need a different material? Is it clinically significant? Is this especially significant in patients with large pupils? Do we need a bigger implant? Do we need a different shaped lens? Do we need a different edge? Do we need a different material? Robert G. Martin, MD Donald R. Sanders, MD, PhD