Unique Aberration-Free IOL:

A VISION THAT PATIENTS CAN APPRECIATE

Akreos AO

2

n Traditional spherical IOLs create spherical aberration and reduce contrast sensitivity

n With Akreos AO, unique aspheric anterior and posterior surfaces are aberration neutral

n The result? Clinical outcomes demonstrate a reduction in overall higher order aberrations1

n Contrast sensitivity under photopic or mesopic lighting conditions is similar to silicone aspheric aberrated IOL2

Total HOA

coma

SA

0.86

0.60

0.500.35

0.52

0.70

2.00

1.80

1.60

1.40

1.20

1.00

0.80

0.60

0.40

0.20

0.00Akreos Adapt

(n=32)Akreos Adapt AO

(n=32)

High Order Aberrations at 3 months: 6mm pupil

1 G. Lofoco. Influence of Aspheric and Spherical IOLs on Higher-Order Aberrations and Functional Vision: Results of a Comparative Multi-center Study. ASCRS 2006.

Bilateral implantation study

120

100

80

60

40

20

0

120

100

80

60

40

20

01,5 3 6 12 181,5 3 6 12 18

Spatial Frequency (CPD)Spatial Frequency (CPD)

Con

tras

t Sen

sitiv

ity

Con

tras

t Sen

sitiv

ity

Akreos AO (n=80) Silicone Aspheric Aberrated IOL (n=80)

Bilateral implantation study

Photopic Contrast Sensitivity: 85 cd/m2

2 B. Johansson et al. Swedish multi-center study to compare the optical performance of the Akreos Adapt Advanced Optic (AO) IOL and the Tecnis Z9000. ASCRS 2006.

An Aspheric Optic for Improved Quality of Vision

Mesopic Contrast Sensitivity: 3 cd/m2

Akreos AO

3

6 months1 yearNormal phakic

population(mean age:

43-year-old)

Akreos AO patients(mean age: 70-year-old)

Akreos AO patients(mean age: 70-year-old)

Normal phakicpopulation(mean age:

43-year-old)

0.3

0.2

0.1

0

-0.1

-0.2

0.3

0.2

0.1

0

-0.1

-0.2

20/40

20/32

20/25

20/20

20/16

20/40

20/32

20/25

20/20

20/16

High Contrast (n=50)

IogM

ar

IogM

ar

Low Contrast (n=50)

1 year6 months

n No eye is optically perfect

n Constant power from centre to edge helps to improve vision by providing consistent power across the entire optic surface

n Akreos AO is designed to provide predictable, repeatable refractive outcomes for all cataract patients, regardless of corneal shape, pupil size, as well as pupil or capsular bag centration

n Clinical results show excellent high and low contrast BCVA comparable to a middle-age phakic eye3

Uniform Power Designed to Work in Every Eye

Fovea

RetinaLens

OPTICAL AXIS(Cornea to Lens)

VISUAL AXIS(Object to Fovea)

Iris

The Natural Phakic Eye

All axes in the eye are not perfectly aligned and no two eyes are the same shape so you need IOLs that work with imperfect conditions.

BCVA compared to phakic eyes

3 V. Pfeifer. Clinical evaluation of a new aspheric IOL: the Akreos Adapt Advanced Optics (AO). Data from a pilot study at six months follow up. ASCRS 2006.

Akreos AO

4

Akreos AOSilicone AsphericAberrated IOL

Z40 – 4mm Z40 – 4,5mm Z40 – 5mm

1

,8

,6

,4

,2

0

-.2

Spherical Aberrations

RM

S

n The phakic eye has some natural level of positive spherical aberration

n Positive spherical aberration helps the phakic eye achieve better depth of field

Aberration-Free Design Helps to Enhance Depth of Field

Depth of focus in intermediate vision

Corneal Central rays

Corneal Peripheral rays

Corneal Medium rays

In intermediate vision more distant objects are seen through central corneal rays whereas closer objects are seen through peripheral corneal rays.

4 Measured with the Strehl ratio as described by S. Marcos et al. Implantation of Spherical and Aspheric IOLs. Journal of Refractive Surgery. May–June 2005; 21:1–13.

Bilateral implantation study

2 B. Johansson et al. Swedish multi-centre study to compare the optical performance of the Akreos Adapt Advanced Optic (AO) IOL and the Tecnis Z9000. ASCRS 2006.

Natural Functionality

n Akreos AO maintains the natural, positive spherical aberrations compared to aspheric, aberrated IOLs2 (top figure)

n With its aberration-free design, Akreos AO helps to significantly improve depth of field in comparison to an aspheric aberrated IOL2 (bottom figure)

Akreos AO Silicone Aspheric Aberrated IOL

Mean Depth of Field4 p=0,03

0.85 Dpt 0.71 Dpt

Number of patients 74 74

Akreos AO

5

Akreos AO28%

SiliconeAspheric

Aberrated IOL14%

40

30

20

10

0

40

30

20

10

0

Akreos AO33%

SiliconeAspheric

Aberrated IOL11%

No di�erence 58%(n=80)

No di�erence 56%(n=55)

n A masked, subjective patient assessment following cataract surgery showed that twice as many patients prefer the vision in their Akreos AO eye2 (left figure)

n Patients also reported fewer visual disturbances in their Akreos AO eye compared to the silicone aspheric aberrated IOL eye2 (right figure)

A Visual Difference Patients Appreciate

Bilateral implantation study: double-masked questionnaire

2 B. Johansson et al. Swedish multi-centre study to compare the optical performance of the Akreos Adapt Advanced Optic (AO) IOL and the Tecnis Z9000. ASCRS 2006.

Less dysphotopsia in one eyeAny preference for one eye

n Patients had no way of knowing which lens was implanted in their eyes

Akreos AO

6

0.25

0.2

0.15

0.1

0.05

0

0.25

0.2

0.15

0.1

0.05

0

0.048

6mm optic area(n=41)

0.012

3mm central area(n=41)

0.039

3mm central area(n=123)

0.114

6mm optic area(n=123)

* Nd:Yag capsulotomy usually performed beyond 0.5 to 1.0, depending on PCO location and patient’s complaint.

n The unique Square-Edge Technology and a 360° posterior barrier reduce cell migration following implantation

n EPCO analysis shows just how effective the Akreos AO design is in blocking cell growth3

n Results are comparable to the best performing acrylic IOLs5

For Optimised Effectiveness against PCO

Akreos Advanced Optics

EPCO Scores @ 12 months

Limit at which PCO does not require Nd:Yag capsulotomy*

Akreos AO3 One-Piece Hydrophobic Acrylic Lens5

3 V. Pfeifer. Clinical evaluation of a new aspheric IOL: the Akreos Adapt Advanced Optics (AO). Data from a pilot study at six months follow up. ASCRS 2006. 5 Data on file.

EPCO Scores @ 3 months @ 6 months @ 12 months

6mm optic area 0.048 0.048 0.048

3mm central area 0.007 0.008 0.012

(n=42) (n=48) (n=41)

Akreos AO

7

n The Akreos Single-Use Insertion Device enables implantation of the Akreos AO through a 2.8mm phaco incision

n The flat loading, single-hand injection makes quick work of lens implantation

Efficient Implantation through an Unenlarged Phaco Incision

Single-Use Lens Delivery System

1. Place the lens flat in to the loading deck 2. Close the injector and fit the tip 3. Advance the plunger and deliver the lens

Akreos™ Single-Use Insertion Device AI-28B

n Improved plunger design provides symmetrical unfolding and easier placement of the lead haptics into the capsular bag

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Belgium/ Tel: +32 3 280 82 40 Luxembourg Fax: +32 3 280 82 59

Emerging Markets Tel: + 33 4 67 12 30 30 Fax: + 33 4 67 12 30 32

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For information or Customer Service please contact your local representative or distributor. Bausch & Lomb European Office, Bausch + Lomb House, 106–114 London Road, Kingston-upon-Thames, Surrey KT2 6TN, UK. Tel: +44 20 8781 5500 Fax: +44 20 8781 2909 www.bauschsurgical.com

Akreos Advanced Optics System

Model: Adapt AO

MATERIAL:

26% acrylic material,

UV absorber, Refractive index: 1.458 (hydrated)

OPTIC:

Biconvex aspheric anterior and posterior, Optic body: 6mm

HAPTICS:

One-piece, 0º angulation

OVERALL DIAMETER:

11.0mm from 0.0 to 15.0 Dpt

10.7mm from 15.5 to 22.0 Dpt

10.5mm from 22.5 to 30.0 Dpt

DIOPTER RANGE:

0.0 through 9.0 in 1.0 Dpt

10.0 through 30.0 in 0.5 Dpt

LENS CONSTANTS: Applanation Immersion A-scan A-scan or IOL Master*

A-Constant* 118.0 118.3 (SRK/T)

ACD* 4.96 5.18

Surgeon Factor* 1.22 1.40

ORDER CODES:

Lens in plastic vial: ADAPTAOP or ADAPTAOTP

Injector: AI-28B

* A-Constant, ACD and Surgeon Factor are estimates only. Latest update March 2011. It is recommended that each surgeon develop his or her own values.