Diffractive Multifocal IOL Prof. Dr. Daniel H. Scorsetti EYEDIFF PLUS +3.50D Diffractive Multifocal IOL “A New Alternative” Prof. Dr. Daniel H. Scorsetti University of the Salvador - Catholic Pontificia University of Argentina Faculty of Medicine - Faculty of Medical Sciences Chair of Ophthalmology Buenos Aires, Argentina

Eyediff Plus +3.50D: Technical Specifications

EYEDIFF Plus Presbyopic IOL Diffractive Technology Perfect Light Distribution for Distance &Near( 60/40)‏ Addresses Cataract Patients with or without Presbyopia Allowed Patients a High Level of Freedom From Glasses in clinical trial

Full Optic Regular Diffractive IOL Advantages Provides multifocal vision Reduced pupil dependency Balanced distribution of light Able to tolerate some decentration

Full Optic Diffractive IOL Disadvantages Potential for Scattering of light and glare and halos at night but Advantages Provides multifocal vision Reduced pupil dependency Balanced distribution of light Able to tolerate some decentration * Creates Halos and scattering Light

Zones

EYEDIFF Plus - Predictable refractive outcome +3.00D Addition

EYEDIFF Plus - Predictable refractive outcome +3.50D Addition

EYEDIFF Plus - Predictable refractive outcome +4.00D Addition

Show Optic Far Intermediate Near

EYEDIFF PLUS – Predictable Customized LIO

EYEDIFF PLUS - Predictable refractive outcome Analysis of the mistake : Square root of the sum of the squares Warren E. Hill, MD, FACS

EYEDIFF PLUS - Predictable refractive outcome Analysis of the mistake : Square root of the sum of the squares Warren E. Hill, MD, FACS

Aspheric Optic (Aberration Neutral)

360° Square Edge

EYEDIFF Plus 360⁰Square Edge Edge thickness correspond to standard designed IOLs Square edge design Perfect centration in the capsular bag Perfect optical performance Extremely low incidence of PCO Anti Z effect Haptic design

IOL Power calculation Careful Keratometry 1.0D corneal power error affects 1.3 to 1.6D IOL power calculation Careful Axial Length 1.0mmAL error affects the post-operative refraction by 1.2 to 2.5D aprox. IOL Master: SRK II--------- 118.6  SRK T--------  118.4   Holladay 1 - sf--- 1.37   Haigis ----- a0=0.95, a1=0.4, a2=0.10   Hofer - pACD-- 5.17 Aim Emmetropia & Astigmatism <1.0D A-Const. & ACD ( Surgeon Factors)‏

Clinical Trial Objective: to compare the visual quality preop and postop., between 2 multifocal IOLs and 1 monofocal Material and methods : 60 eyes of 30 pts. divided into 3 groups, informed and signed assent, cataract degrees II and III, older than 55 years (average 60 years), without ocular disease or astigmatism > 1.0D. Bilateral implants, the same IOL in every patient (not mix and match) Equipment: Alcon Infinity Technique : Facotorsional with Ozil IP, 2.2mm (intrepid) Incision in the steepest axis and the same protocol in all cases Group 1: 10 pts. Acrysoft IQ Group 2: 10 pts. Acrysoft Restor Group 3: 10 pts. EYEDIFF PLUS +3.5D

Clinical Trial Preop Complete ocular exam: UCVA & BCVA: far, intermediate (70 cm) and near (40 cm) Pentacam HR IOL Master Contrast Sensibility : photopic and mesopic NEI VFQ-25 Questionnaire with Apéndix NEI VFQ-39 (in Spanish) 6 questions to evaluate visual general health 20 questions to evaluate difficulties in visual activities 13 questions to evaluate level of acceptance of visual loss NEI VFQ: National Eye Institute, Visual Function Questionnaire

Clinical Trial Postop complete examination : days 1 - 7- 30 - 90 UCVA & BCVA: far, intermediate (70 cm) and near (40 cm) Pentacam HR Contrast Sensibility : photopic and mesopic NEI VFQ-25 Questionnaire with Apéndix NEI VFQ-39 (in Spanish) 6 questions to evaluate visual general health 20 questions to evaluate difficulties in visual activities 13 questions to evaluate level of acceptance of visual loss Follow-up 3 months

Results Questionnaire Group 2 and 3: better in postop. to read newspaper and close vision activities. Group 3: less difficulty in night driving, But without statistically significant difference with 2. Group1: statistical significant difference to favor to drive by night Without intraop complications Without PCO Descentrations 2 minor in group 2 1 minor in group 3 Halos/Glare 3 tolerable in group 2 2 tolerable in group 3

Results FAR – GROUP 1: Acrysoft IQ UCVA BCVA

Results FAR – GROUP 2: Acrysoft Restor UCVA BCVA

Results FAR – GROUP 3: EYEDIFF PLUS UCVA BCVA

Results NEAR – GROUP 2: Acrysoft Restor UCVA BCVA

Results NEAR – GROUP 3: EYEDIFF PLUS AV S/C AV C/C

Intermediate Vision (70 cm) GROUP 2 Acrysof Restor DECIMAL DISTANCE INTERMEDIATE WITHOUT CORRECTION 0.4 70 cm INTERMEDIATE WITH CORRECTION 1.0 GROUP 3 – EYEDIFF PLUS DECIMAL DISTANCE INTERMEDIATE WITHOUT CORRECTION 0.5 70 cm INTERMEDIATE WITH CORRECTION 1.0

EYEDIFF Plus

EYEDIFF Plus

Conclusions Less adverse effects Good results post-surgery Individual map with MTF and topography of IOL power Variety of powers for near First Customized IOL Cost

Thank you very much!!! danielhs@arnet.com.ar