WHY WHY MINIFLEX TORIC? TORIC?

Dr. Gilberto Akio Shimoda

Centro de Microcirurgia Ocular de Atibaia

WHY USE MINIFLEX TORIC?

• USE ONE PLATAFORM KNOWN – 70.000 MINIFLEX IMPLANTED AROUND THE WORD

• MateriaL - biocompatibility• Design• Overall diameter• Haptics design.

Mater ia l

H Y B R I D A C RY L I C - F L E X A C RY L ®

Flexacryl is a unique copolymer that combines hydrophobic and hydrophilic

monomers with a long history of safe and effective intraocular use .

The use of blue light blocking chromophores in some IOL materials may lead to

undesirable side-effects such as loss of contrast sensitivity and impact the

circadian physiology which regulates biorhythm. Strong scientific evidence

documents that the progressive yellowing of the aging human lens is related to the

high incidence of sleep disorders and depression in the elderly.

The new exclusive Natural Yellow® Chromophore used on MINIFLEX TORIC is a

hydroxykynurenine compound, the natural yellow chromophore found in the human

lens. This chromophore was synthesized and incorporated to the product so as to

allow MINIFLEX TORIC to have the same light absorption level as seen in the lens

of a 20 year old youngster: UVA blockage of up to 400nm, potent violet filter and

mild dark blue filter.

U V F I LT E R A N D N AT U R E Y E L LOW F I LT E R ®

MINIFLEX TORIC new Natural Yellow® chromophore is a hydroxykynurenine

compound, the very same yellow chromophore that occurs naturally in the

human lens. Using the same chromophore selected by nature through

hundreds of thousands of years of evolution of the human species is the most

physiologic solution to filter out potentially harmful wavelengths while still

allowing healthy blue light in. This protects the retina, enhances contrast

sensitivity and do not interfere with the patient’s biologic cycles.

Aberration-Free Aspheric Optics

MINIFLEX TORIC features a unique aspheric optic design optimized by state-

of-the-art ray tracing software. Unlike other aspheric intraocular lenses in

which negative spherical aberration is induced, MINIFLEX optics is free from

spherical aberrations, allowing for greater depth of focus and maintaining both

visual acuity and contrast sensitivity intact in case of decentration.

Opti cs Des ign NEUTRAL

1 . 8 m m I N J E C T I O N S Y S T E M

MINIFLEX TORIC inaugurated a new era for

microincision cataract surgery. The material’s high

pseudoplasticity and the visco-injection system allow

for smaller incisions compared to other IOLs, without

sacrificing optical diameter or stability. MINIFLEX

TORIC can be implanted through a 1.8mm incision

using a docking injection technique or 2.2mm with

the cartridge introduced in the anterior chamber.

MINIFLEX TORIC IS THE IDEAL IOL FOR M.I.C.S

Designed for M.I.C.S

SELF-CENTERING DOUBLE HAPTICS

MINIFLEX TORIC haptics design equalizes compression forces as the capsular bag contracts, providing optimal fit to bags of all sizes.

STEP- VAULT HAPTIC AGULATION

• Keeps the haptics in parallel alignment with the optic at all times.• Prevents optical torsion and tilting.• Concept validated in conformity to ISO-11979 as to optic torsion (<5º).

Long Term Stabi l i ty

B U F F E R C AV I T Y

• Absorbs the mechanical stress generated by haptic compression.

• Isolates the optics from the haptic compression forces, even in the presence of strong capsular contraction, thus avoiding descentration.

• Concept validated through advanced finite element analysis software.

LARGE CAPSULAR CONTACT ARC

MINIFLEX TORIC haptic design provides a wide area of contact between the haptics and the equatorial fornix of the capsular bag, improving IOL stability.

3 6 0 º S Q U A R E D E D G E

MINIFLEX TORIC® has a square edge on its

posterior face, creating a 360° block against

cellular proliferation, even in the haptic-body

junction areas. The compression presses the

optic posteriorly so that the IOL maintains full

contact with the posterior capsule. This eliminates

empty spaces while the squared edge blocks

unwanted cell migration.

Superior Protection against PCO

Specifications - MINIFLEX TORIC

USA Patent deposited under # US 61/971,867

- Spherical power:

- Cylindrical power:

- +10.0D to +30.0D in steps of 0.50D

*NOTE: Special diopters available upon request

- +1.5D ; +2.25D ; +3.0D ; +4.0D ; +5.0D; +6.0D

Availability*

CORNEAL CYLINDER CORRETION

IOL´s cylinder power (D)

Cylinder correction corneal plane

(D)

1.50 0.91

2.25 1.36

3.00 1.82

4.00 2.43

5.00 3.04

6.00 3.65

AXL 23,50 / ACD 3.2 / SEQ 20D

Design Benefi ts of Minifl ex Tor ic

• Importance in stability within the capsular bag, preventing rotation postoperatively. Aided by anti rotational (AR) system.

• The haptic design absorbs the mechanical forces generated by haptic compression, not allowing such forces to be transferred to the IOL.

• The total diameter of the lens is also important for preventing IOL rotation postoperatively .

Design Benefi ts of Minifl ex Tor ic

• 5 degrees angulation of the haptics in relation to the

optics facilitates adhesion to the posterior capsule.

• Secure platform with follow up of more than 7 years.

• Precision of astigmatism correction.

• Better quality of vision due to the neutral aberration

aspheric lens design.

Patient selection - Indication

• Patients candidate for cataract surgery

with astigmatism ≥ 0,75D;

• Patients with regular astigmatism (bowtie);

• Without ectasias;

• Stable keratoconus (critical evaluation)

Patiente selection - Contraindication

• Irregular Astigmatism (relative);

• Corneal pathologies (Keratoconus, scar) (relative);

• Pre-existing eye disease (relative);

• Unstable capsular bag, zonular trauma;

• Comorbidities: amblyopia, maculopathy, glaucoma,

uveitis.

WHY MINIFLEX TORIC

• Increases spectacle-independent distance vision,

• Predictable treatment • Reduces or eliminates cylinder power ,• Improves bilateral UDVA, • More effective and predictable than relaxing

incision.

PRE SURGERY TechniquesIOLMASTEROCTESPECULAR MICROSCOPEPAM(OPTIONAL – MONOFOCAL)ASTIGMATISM ABOVE 0.75DCALCULATOR

Online Calculator

Online Calculator

• Surgion name• Patient name• Eye syze(mm)• ACD – to epitélium (mm)• Eye OD ou OS• Unit Keratomic: diopter

or mm

• Spheric power of IOL(D)• Flat K (D or mm)• Flat axis (degrees)• Step K (D or mm)• Surgical induces

astigmatism (D)• Incision axis (degrees)

• Exclusive Anti-rotational System,• Natural Yellow chromophore,• Hybrid material,• Micro incision down to 1.8mm,• Online calculator with friendly interface,• IOL mark with easy visualization,• Easy manipulation inside the eye.

Miniflex Toric – Summary

TALITA YOKO SHIMODA, MD

TALITA YOKO SHIMODA MDCo-Authors: Gilberto Akio Shimoda,Gabriel A. Shimoda, Hugo Araki, Paulo Kin Takara

CENTRO DE MICROCIRURGIA OCULAR ATIBAIA – ATIBAIA- BRAZIL

NO FINANCIAL INTEREST

CHECKING THE IOL AXIS IMMEDIATELY AFTER CATARACT SURGERY AND TORIC IMPLANTATION WITH OPD-SCAN III®, USING MANUAL MARKER AND ELETRONIC MARKER

SURGERY TECHNIQUEANESTHESIA – TOPICAL – TETRA VISC – OCUSOFT™ PERIBULBAR ALSO POSSIBLEAXIS MARKER – ELETRONIC OR MANUAL MARKERCAPSULECTOMY – 4 A 5 MMPOCKET OR SUTURECHECK THE LENS AXIS IMMEDIATELY AFTER SURGERY WITH OPDSCAN. –REAL TIMEABOVE 5º REPOSITION THE LENS TO CORRECT AXIS IMMEDIATELY UNDER MICROSCOPE.

CHECKING THE RESULTS1- PATIENT SATISFACTION VA – 20/30 OR BETTER Bye!bye!2- PATIENT AND DOCTOR SATISFACTIONVA – 20/30 OR BETTER AND NO GLASSES FOR DISTANCEANDLENS ALIGMENT – OPDSCAN – LENS IN CORRECT AXIS.FANTASTIC RESULTS.

THANK YOU