A new generation of premium lenses promises to offer opportunities for increasingly accurate refraction, customized to the individual patient.
“It is a changing scenario in which cataract and refractive lens exchange (RLE) patients can expect considerably better results, major advantages and fewer problems. It is going to be an exciting time, with a lot of innovation in technologies, a brighter future for the patients and expansion for the market,” Jorge L. Alió, MD, PhD, OSN Europe Edition Board Member, said.
The growing market of multifocal IOLs currently offers two main options. On one hand there is a variety of innovative-design diffractive implants, and on the other hand, a new type of refractive varifocal optics.
The Lentis Mplus is the main lens in the varifocal group and is part of a family of lenses developed by Oculentis that focuses on patient selection.
“Patients are classified as dominant for far, intermediate or near, according to their lifestyle requirements,” Alió explained.
The Mplus family IOLs are asymmetric, with a sector-shaped near vision zone, the same plate haptics but different additions.
The first Lentis Mplus had a 3 D addition, and then a new member of the family, the Mplus X, was created for better near vision.
“I strongly advocated this change because I found that the near add was not satisfactory enough, particularly for women. The sector for near vision was enlarged, the transition zone was optimized, a new central aspheric optic part was included, and now patients are able to read small print without glasses,” Magda Rau, MD, OSN Europe Edition Board Member, said.
Another option offered by Oculentis is the Lentis Comfort, with an addition of 1.5 D. The lower addition sacrifices some near vision but minimizes glare and halos.
“I like to offer this lens to men, who tend to be intolerant to halos and glare and wish in spite of that independence from glasses. I usually start by implanting this lens in the dominant eye, and if the patient is satisfied, I implant the same lens in the second eye. If more near vision is wanted, I implant the Mplus with 2 D or 3 D addition,” Rau said.
The Lentis Mplus toric is individually custom made in a large range for sphere from 0 D to 36 D and for cylinder from 0.25 D to 12 D. It is available in 0.01 D steps to enable the correction of sphere, astigmatism and presbyopia.
“Until now, I have indicated the Lentis Mplus toric up to 1.5 D of astigmatism, but now if the patient can afford it, I also use it to correct low astigmatism, like 0.75 D to 1 D, because this improves VA especially for distance but also intermediate and near,” Rau said.
“There is also a model for low vision in the Mplus family, which is going to make quite a difference in the lives of patients with AMD who still have sufficient near vision. They are going to be able to read in better conditions and do away with the problems related to spectacles and magnifiers,” Alió said.
Another model for specific needs is the myLENTIS, currently under investigation in a European multicenter trial.
“It is not a multifocal, but focuses on ocular aberrations and specifically aims at patients who have had previous corneal refractive surgery, particularly patients operated years ago with primitive models of lasers or lasers that have been used by inadequate hands. An emerging group who need correction of ametropia but also correction of aberrations. Keratoconus patients are also candidates,” Alió said.
The lens will be custom made for individual patients.