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.

Bausch & Lomb today announced the worldwide launch of a new accommodating intraocular lens (IOL) with aspheric optics for use in cataract surgery.

The new IOL, called Crystalens AO, is designed to be free of spherical aberration that affects other IOLs and thereby produce sharper vision after cataract surgery. The announcement follows recent FDA approval of the Crystalens AO for use by cataract surgeons in the United States.

The aspheric optical surfaces of Crystalens AO are designed to improve retinal image quality without compromising depth of field, and therefore the new IOL provides higher quality distance and intermediate vision than other IOLs, according to the company.

“The Crystalens AO has zero spherical aberration, and the combination of the Crystalens platform and AO optics work together to enhance depth of field,” says Andy Corley, president of Bausch & Lomb’s global surgical division in a press release issued today by the company.

The Crystalens AO is the latest addition to the Crystalens line of accommodating IOLs produced by Bausch & Lomb, joining the Crystalens HD and the Crystalens Five-O. Currently, Crystalens is the only brand of accommodating IOL that is FDA-approved for use in cataract surgery performed in the United States.

Unlike conventional IOLs, the optical portion of accommodating IOLs can move slightly within the eye in response to focusing effort, to improve not only distance vision, but intermediate and near vision as well, reducing the need for reading glasses after cataract surgery.

Accommodating IOLs are a premium intraocular lens and therefore will increase your cataract surgery cost.

More information about Crystalens accommodating IOLs is available on Bausch & Lomb’s Crystalens website or by calling the company at 1-877-SEE BETTER.

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.

The use of premium intraocular lenses (IOLs) in cataract surgery performed in the United States is increasing, according to recent surveys.

Premium IOLs include multifocal lens implants and accommodating IOLs. Both types of presbyopia-correcting intraocular lenses give patients a broader range of vision, reducing or eliminating the need for reading glasses after cataract surgery.

According to a recent survey of cataract and refractive surgeons reported by the eyecare industry research firm Market Scope, 71 percent of U.S. eye surgeons offered their patients the option of premium IOLs in 2008, up from approximately 59 percent in 2007. The company also estimates that 210,000 presbyopia-correcting IOLs were implanted during cataract surgery or other vision correction procedures in the U.S. in 2008, up from 153,000 in 2007.

Eye surgeons also say they prefer premium IOLs for the correction of high myopia. In a 2008 member survey of the American Society of Cataract and Refractive Surgery (ASCRS) more eye surgeons responding to the survey reported preferring premium IOLs (40 percent) to LASIK (23 percent) for the correction of large amounts of nearsightedness in patients desiring elective refractive surgery.

Among ASCRS surgeons using presbyopia-correcting premium IOLs, their top three lens choices in 2008 were the AcrySof ReSTOR multifocal IOL (Alcon), the Crystalens accommodating IOL (Bausch & Lomb) and the ReZoom Multifocal IOL (Abbott Medical Optics).

Other premium intraocular lenses include toric IOLs that correct astigmatism and aspheric IOLs designed to reduce glare and improve night vision.

Premium IOLs cost more than standard IOLs, and the added expense of these lenses typically is not covered by vision insurance and must be paid out-of-pocket, increasing your cataract surgery cost. However, most people who choose premium IOLs are very pleased with the added visual benefits the lenses provide, according to eye surgeons who offer them.