All About Cataracts

Crystalens HD, an accommodating intraocular lens (IOL), is producing excellent visual outcomes and a high degree of independence from eyeglasses after cataract surgery, according to three European eye surgeons.

The surgeons presented their findings at the 2010 winter meeting of the European Society of Cataract and Refractive Surgeons, held in Budapest, Hungary, February 12-14.

Mark Tomalla, MD, of Duisburg, Germany, said he has implanted the Crystalens HD accommodating IOL in a series of 48 patients. At the time of his presentation, 17 of these patients had been been evaluated at a 6-month follow-up visit.

Six months after surgery:

• All patients could see clearly in the distance and at arm’s length without glasses.
• 71 percent reported they did not need reading glasses.
• The remaining 29 percent said they needed reading glasses only occasionally.

Angel Lopez-Castro, MD, reported similar results in his surgical implantation of the Crystalens HD after cataract removal in the eyes of 42 patients in Madrid, Spain. He said 80 percent of these patients achieved uncorrected reading vision of 20/25 or better, and all patients had distance vision of 20/20 or better without glasses.

Kristien Vanhoucke, MD, of Mol, Belgium, reported that 6 months after implanting the Crystalens HD in 26 eyes, 90 percent of these patients reported good vision at all distances and freedom from glasses after cataract surgery.

Crystalens HD is the fourth-generation accommodating IOL produced by Bausch & Lomb (Rochester, NY). The company received approval from the U.S. Food and Drug Administration (FDA) in June 2008 to market Crystalens HD in the United States.

In January 2010, Bausch & Lomb announced the introduction of Crystalens AO, its latest accommodating IOL that is designed to reduce higher-order aberrations for even sharper vision after cataract removal.

All Crystalens accommodating IOLs are premium intraocular lenses and therefore increase cataract surgery cost. Ask your cataract surgeon for details.

SOURCE: Multiple European clinics report promising accommodating IOL visual outcomes. Ocular Surgery News. Published online February 15, 2010.

In its December 15 issue, Ophthalmology Times published a “year in review” feature, highlighting key developments in cataract surgery that took place in 2009.

Advances in cataract surgery technology in 2009 included:

Approval of femtosecond laser technology for cataract surgery

In September, the LenSx laser (LenSx Lasers, Inc., Aliso Viejo, Calif.) became the first femtosecond laser to gain FDA approval for a specific step in the cataract surgery procedure, eliminating the need for a bladed instrument for this step. Proponents say femtosecond laser technology (currently used primarily for LASIK and other laser vision correction procedures) could make a cataract operation even more safe and effective, reducing the risk of certain cataract surgery complications.

New multifocal IOLs

Two new multifocal IOLs were introduced to the U.S. market in 2009: the Tecnis Multifocal IOL (Abbott Medical Optics, Santa Ana, Calif.) and the AcrySof IQ ReSTOR +3.0 D (Alcon Laboratories, Fort Worth, Texas). Both lenses are designed to help patients regain a fuller range of vision after cataract removal and reduce their need for reading glasses. According to preliminary studies, both lenses offer patients a higher degree of freedom from glasses than previous multifocal intraocular lenses.

Investigational IOLs

A number of companies were conducting clinical trials of new premium IOLs not yet approved for use in the United States. These include a “light-adjustable lens” (LAL) being developed by Calhoun Vision (Pasadena, Calif.). The power of this lens can be adjusted by exposing it to a specific wavelength of light 2 to 3 weeks after cataract surgery, depending on the patient’s visual needs.

Another premium IOL under study is an accommodating IOL called the NuLens (NuLens, Ltd., Herzeliya, Israel and Alicante, Spain). Preliminary studies suggest the NuLens can produce significantly greater near focusing power than currently available accommodating IOLs for even greater freedom from reading glasses after surgery.

SOURCE: 2009: A banner year in cataract surgery. Ophthalmology Times. December 15, 2009.