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Nothing can stop the technology train—not even the ongoing pandemic—and that senti-ment is especially true when we look at the technology of IOLs,

which continues to advance and grow. That’s a good thing, as cataracts are a leading causes of blindness worldwide.1 More than 90% of people will develop cataracts by age 65, and half of those between ages 75 and 85 will have lost some vision due to a cataract.2 Following is a brief overview of some of the new-est IOLs on the US market—and some not quite here yet (also see Table). [Note: The listing is in alphabetical order by IOL name. Any products not mentioned were excluded unintentionally.]

ACRYSOF IQ VIVITY The FDA in February approved

the AcrySof IQ Vivity Extended

Vision IOL (Alcon), along with toric, UV-absorbing, and toric UV-absorbing versions of the lens.3 The AcrySof IQ Vivity became commercially available in selected European mar-kets in March.4 In a news release, the company announced that it plans to focus on the ongoing launch of its AcrySof PanOptix Trifocal IOL in the United States and launch Vivity as a complementary lens in more markets throughout this year.4

ACRYSOF PANOPTIX TRIFOCALThe AcrySof PanOptix Trifocal IOL

(Alcon) was approved by the FDA and launched in the United States in August.5 The PanOptix is the only tri-focal lens available in the United States for patients undergoing cataract sur-gery. Bobby Saenz, OD, MS, FAAO, and Thomas Nettleton, OD, wrote about

this new IOL in the September issue of MOD. Visit bit.ly/MODseptPanOptix to read about how it changed their approach to cataract surgery. bit.ly/AlconIOLs

ENVISTA TORIC The enVista toric IOL (Bausch

+ Lomb) is an aspheric, aberration-free, biconvex, posterior-surface toric, one-piece hydrophobic acrylic lens indi-cated for prima-ry implantation in the capsular bag of the eye in adults for the visual correction

IOL ROUNDUPStay in the know regarding available and upcoming advanced-technology surgical options. BY KAREN ROMAN, EDITOR-IN-CHIEF

The enVista toric IOL.

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of aphakia with corneal astigmatism following removal of a cataractous lens for improved distance vision. www.bausch.com/our-products/surgical-products/cataract-surgery/envista-toric-iol

FINE VISION TRIUMF IOLBVI, through its PhysIOL subsidiary,

in September launched the FineVision Triumf EDOF trifocal presbyopia-correcting IOL, indicated for implan-tation in patients undergoing cataract surgery.6 According to the company, the lens combines trifocal technology with elongated depth of focus (EDOF) presbyopia-correcting optics to reduce chromatic aberrations, glare, and halos.7 www.physiol.eu/en-US/Products/Intraocular-lenses

IC-8The IC-8 small aperture IOL

(AcuFocus) is a clear, aspheric mono-focal lens with an embedded pinhole in the center. This lens uses small-aperture technology to increase a patient’s natural range of vision by protecting central organized light rays that enter the eye and restricting peripheral light rays that degrade image quality and range of focus, according to the company. Studies show that the IC-8 lens is highly effec-tive when implanted in one eye only.8

In July, AcuFocus announced an extended diopter range for the IC-8, from +10.00 D to +30.00 D (in 0.50 D steps).9 The IC-8 IOL is not approved for use in the United States. www.acufocus.com/us

INTENSITYThe Intensity IOL (Hanita Lenses)

is a presbyopia-correcting IOL that was developed with the help of a

proprietary iterative algorithm called Dynamic Light Utilization technology for better light efficiency. The com-pany says the profile of the lens enables continuous, uninterrupted vision throughout the entire vision range. The profile of the Intensity IOL includes 12 smooth steps and a central ring 1 mm in diameter. Step heights vary along the lens radius, with a maximum step height of 3.6 µm. The Intensity has the CE Mark and is commercially available in Europe. www.hanitalenses.com

JUVENEThe Juvene Intraocular Lens

(LensGen) is an investigational device designed to address both presbyopia and astigmatism. The IOL was first implanted in pilot studies in 2015 and is not available for use or sale in the United States, although the company says it expects the lens to be commer-cialized by 2023. lensgen.com

LIGHT ADJUSTABLE LENSThe Light Adjustable Lens (RxLAL,

RxSight) is a three-piece lens that fea-tures a biconvex optic composed of photoreactive UV light-absorbing sili-cone that allows postoperative adjust-ment of IOL power with the Light Delivery Device (LDD; RxSight). Learn more about the lens from Kayla L. Karpuk, OD, and William F. Wiley, MD, in an article they wrote in Collaborative EYE: bit.ly/CEsept19LAL.

SBL-3The SBL-3 Segmented Bifocal Lens

(Lenstec) is a presbyopic IOL intended to provide superior high-definition vision. According to the company, the SBL-3 is an asymmetric segmented mul-tifocal IOL designed to improve contrast sensitivity, minimize halos and glare, and provide superior near, intermediate, and distance vision compared with other presbyopic IOLs. Lenstec in March sub-mitted data on the SBL-3 to the FDA for premarket approval in the United States. www.lenstec.com

TECNIS SYMFONY PLUS Modeled after the Tecnis Symfony

(Johnson & Johnson Vision), the Tecnis Symfony Plus extended range of vision one-piece IOL offers stron-ger near vision by about 1 line of near visual acuity and incorporates a violet-light–blocking chromophore intended to compress chromatic aberration, which could reduce dysphotopsia, improve contrast acuity, and provide further retinal protection.10 The Tecnis Symfony Plus is expected to be available in the United States in the near future.

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The IC-8 small aperture IOL.

The SBL-3 Segmented Bifocal Lens.

The Tecnis Symfony Plus IOL.

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TABLE. IOL Spec Sheet

OPTIC DESIGN OPTIC SIZE

OVERALL LENGTH

HAPTICS DIOPTER RANGE AVAILABILITY

AcrySof IQ PanOptix (Alcon)

Trifocal 6.0 mm 13.0 mm Stableforce Modified-L

+6.00 D to +30.00 D in 0.50 D increments

FDA approved

AcrySof IQ Vivity (Alcon)

Biconvex wavefront-shaping

6.0 mm 13.0 mm C-loop platform +15.00 D to +25.00D in 0.50 D increments

FDA approved

enVista toric IOL (Bausch + Lomb)

Aspheric, aberration-free, biconvex, posterior-surface toric

6.0 mm 12.5 mm Modified C, fenestrated

+6.00 D to +30.00 D in 0.50 D increments

FDA approved

FineVision Triumf EDOF (PhysIOL)

Bioconvex aspheric 6.0 mm 11.4 mm Double C-loop and Ridge Tech

+10.00 D to +35.00 D in 0.50 D increments

Europe and certain international markets

IC-8 (AcuFocus) Aspheric monofocal 6.0 mm 12.5 mm Modified C +10.00 D to +30.00 D in 0.50 D increments

Selected markets across Europe and Asia

Light Adjustable Lens (RxSight)

Biconvex 6.0 mm 13.00 mm Modified C adjustments of -2.00 D to +2.00 D of refrac-tive error and 0.75 D to 2.00 D of cylinder

FDA approved

SBL-3 (Lenstec) Bi-aspheric zero-aberration optic

5.75 mm 11.0 mm Modified plate +10.00 D to 36.00 D in 0.50 D steps; +15.00 D to 25.00 D in 0.25 D steps

Data submitted to FDA

Tecnis Symfony Plus IOL (Johnson & Johnson)

Biconvex, wavefront-designed anterior aspher-ic surface, posterior achromatic diffractive surface, echelette feature

6.0 mm 13.0 mm C, offset from optics

+5.00 D to 34.00 D in 0.50 D increments

FDA approved

Tecnis Synergy (Johnson & Johnson)

Biconvex, wavefront-designed anterior aspheric surface and ChromAlign technology

6.0 mm 13.0 mm Tri-Fix; haptics offset from optics

+5.00 D to +34.00 D in 0.50 D increments

Approved in European markets, Australia, and New Zealand

Tecnis Toric II (Johnson & Johnson)

Biconvex, anterior toric aspheric surface

6.0 mm 13.0 mm Tri-Fix, modified C, integral with optic; squared and frosted haptics offset from optics

+5.00 D to 34.00 D in 0.50 D increments

FDA approved

xact Mono-EDoF (Santen)

Biconvex, aspheric EDoF diffractive

6.0 mm 12.5 mm Modified C +10.00 D to +30.00 D in 0.50 D increments

Selected distributors in Europe

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TECNIS SYNERGY IOLJohnson & Johnson Vision intro-

duced the one-piece Tecnis Synergy IOL in Europe in September 2019.11 The Tecnis Synergy is a presbyopia-correcting IOL that allows patients to experience continuous high-contrast vision from far through near, even in low-light conditions, according to the company. The Tecnis Synergy IOL is commercially available across Europe, including the United Kingdom, Italy, France, Spain, and Germany. It is also available in Australia and New Zealand. It is not available in the United States.

TECNIS TORIC IIThe Tecnis Toric II 1-Piece IOL

(Johnson & Johnson Vision) was approved by the FDA and launched in the United States in December 2019. It is the first product approved on the new Tecnis Toric II platform, which, accord-ing to the company, offers more surface texture and friction on the IOL haptics in order to hold the IOL in proper position within the eye. www.jnjvisionpro.com

XACT MONO-EDOFSanten in September 2019

announced the European launch of

its novel monofocal hydrophobic IOL, the xact Mono-EDoF.12 According to Santen, the xact Mono-EDoF with its four diffractive rings provides excel-lent visual acuity at far distances as expected from a typical monofocal IOL, while also offering functional visual acuity at intermediate distanc-es. Its novel continuous range of focus optical design results in no significant visual side effects, with performance similar to that of typical monofocal IOLs. www.santen.eu/our-scientific-focus/technologies

KNOWLEDGE IS POWER Ours is an intelligent, technologi-

cally advanced society. Gone are the days of having only a handful of IOL options from which to choose. For medically minded optometrists in today’s progressive health care culture, when it’s increasingly neces-sary for health care providers to col-laborate in the care of their patients, it’s important to know what vision correction options are available to your patients so that you can bet-ter guide them in making the best decisions for their care. We hope this overview of IOL technologies helps you to do just that. n

1. Global Initiative for the Elimination of Avoidable Blindness: Action Plan 2006-2011. World Health Organization. www.who.int/blindness/Vision2020_report.pdf. Accessed September 21, 2020. 2. Cataract. Kellogg Eye Center. www.umkelloggeye.org/conditions-treatments/cataract. Accessed September 21, 2020.3. AcrySof IQ Vivity Extended Vision Intraocular Lens (IOL) (Model DFT015), AcrySoft IQ Vivity Toric Extended Vision IOLs (DFT315, DFT415, DFT515), AcrySof IQ Vivity Extended Vision UV Absorbing IOL (DAT015), and AcrySof IQ Vivity Toric Extended Vision UV Absorbing IOLs (DAT315, DAT415, DAT515) – P930014/S126. FDA. Recently Approved Devices. 12 March 2020. www.fda.gov/medical-devices/recently-approved-devices/acrysoftm-iq-vivitytm-extended-vision-intraocular-lens-iol-model-dft015-acrysoftm-iq-vivitytm-toric. Accessed September 21, 2020.4. Alcon announces European launch of Vivity, the only presbyopia-correcting intraocular lens with X-Wave technology [press release]. Alcon. 12 March 2020. www.alcon.com/media-release/alcon-announces-european-launch-vivity-only-presbyopia-correcting-intraocular-lens-x. Accessed September 21, 2020. 5. Alcon Laboratories, Inc. AcrySof IQ PanOptix Trifocal Intraocular Lens (Model TFNT00) and AcrySof IQ PanOptix Toric Trifocal Intraocular Lens (Models TFNT30, TFNT40, TFNT50, TFNT60). FDA. Recently Approved Devices. 11 September 2019. www.fda.gov/medical-devices/recently-approved-devices/alcon-laboratories-inc-acrysofr-iq-panoptixr-trifocal-intraocular-lens-model-tfnt00-and-acrysofr-iq. Accessed September 21, 2020.6. PhysIOL to launch FineVision Triumf – the first and only trifocal EDOF IOL [press release]. PhysIOL. 9 September 2019. www.physiol.eu/en-US/News/News/All-news/PhysIOL®-to-Launch-FineVision-Triumf®–-the-First-a. Accessed September 21, 2020.7. Data on file, PhysIOL. Optical benchtop analysis.8. Dick HB, Piovella M, Vukich J, Vilupuru S, Lin L; Clinical Investigators. Prospective multicenter trial of a small-aperture intraocular lens in cataract surgery. J Cataract Refract Surg. 2017;43(7):956-968.9. AcuFocus announces extended diopter range for the IC-8 small aperture IOL [press release]. AcuFocus. 28 July 2020. bit.ly/AcuFocusIC-8. Accessed September 21, 2020. 10. J&J gains approval of Tecnis Symfony Plus lens. Market Scope. 15 May 2020. www.market-scope.com/pages/news/4470/jandj-gains-approval-of-tecnis-symfony-plus-lens. Accessed September 22, 2020.11. Johnson & Johnson Vision introduces Tecnis Synergy IOL, a continuous-range-of-vision intraocular lens (IOL) at the ESCRS 2019 Congress [press release]. Johnson & Johnson Vision. 16 September 2019. www.jjvision.com/press-release/johnson-johnson-vision-introduces-tecnis-synergytm-iol-continuous-range-vision. Accessed September 20, 2020.12. Santen introduces the xact Mono-EDoF in Europe – the monofocal IOL with true extended depth of focus [press release]. Santen. 16 September 2019. www.santen.eu/our-vision/emea-news/santen-introduces-xacttm-mono-edoftm-europe-monofocal-iol-true-extended-depth. Accessed September 18, 2020.

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