Treating a high hyperopic with EDOF IOLs: A Case Report Dr. Florian - - PowerPoint PPT Presentation

www.augenklinik.de

Augenärzte Gerl, Kretz & Kollegen Head Office Am Schloßgraben 13 48683 Ahaus Germany Email: f.kretz@augenklinik.de Tel.: +49-2561-9555675

Provisus Research Institute

Treating a high hyperopic with EDOF IOLs: A Case Report

• Dr. Florian T.A. Kretz, FEBO

Financial Disclosure

Acufocus1 Alimera2,3,4 AMO1,2,3 AVS1 Carl Zeiss Meditec1,2,3,4 Glaukos 1,2,3,4 Hoya1 LensAR1 Mediphacos1 MST4 Oculentis1,2,3,4 ODC4 PhysIOL1 Polytech1,2,3,4 Santen1 Teleon1,2,3 Vision Ophthalmology Group2,3,4

1 = Research; 2 = Travel Expenses 3 = Honorary; 4 = Consulting

Univ.- Augenklinik Universität Heidelberg

Cooperations

Provisus Research Institute

Provisus Research Institute

The patient

• Female, 51 years old
• Bilateral presbyopia
• Daily life activities require Intermediate (iPad and computer work) and Far

vision with low tolerance of dysphotopsia (Night driving) => Patient demands spectacle independence in those distances

• Presbyopic, hyperopic:
• OD: +4.00, -0.25 (85°)
• OS: +4.25, -0.5 (106°)
• History of dry eyes, shallow anterior chamber with history of angle closure

glaucoma (YAG laser iridotomy in 2012)

• CDVA preoperatively= 0.1 logMAR (Binocular and Monocular)

Provisus Research Institute

PENTACAM:

OD OS Flat Cornea Shallow anterior chamber

Provisus Research Institute

Complicated Cases: IOL calculation team Carl Zeiss Meditech in Berlin IOL Power calculation

Provisus Research Institute

The IOL: EDoF AT LARA 829MP

• Surgery:
• Same surgeon
• One day time difference
• Bilateral implantation of

AT LARA 829MP

• OD:
• IOL Power=30D
• Targeted refraction= 0.06D
• OS:
• IOL Power=31D
• Targeted refraction=-0.38D

Provisus Research Institute

RESULTS: Refraction Postoperative Subjective Refraction:

• OD: +0.25
• OG: 0, -0.25 (2°)

Spherical Equivalent:

• OD= +0.25 D (+3.875 Pre-op)
• OG=-0.125 D (+4.00 Pre-op)

Provisus Research Institute

Binocular and Monocular VA

UDVA CDVA DCIVA 90cm DCIVA 80cm DCIVA 60cm DCNVA 40cm MONOCULAR

• 0.09
• 0.09
• 0.04
• 0.03
• 0.02

0.09 BINOCULAR

• 0.09
• 0.09
• 0.14
• 0.2
• 0.07

0.09

• 0,25
• 0,2
• 0,15
• 0,1
• 0,05

0,05 0,1 0,15 0,2 0,25

UDVA CDVA DCIVA 90cm DCIVA 80cm DCIVA 60cm DCNVA 40cm

VA in logMAR

MONOCULAR BINOCULAR

Provisus Research Institute

Binocular and Monocular Defocus Curves

• 0,2
• 0,1

0,1 0,2 0,3 0,4 0,5 0,6 0,7 0,8 0,9

• 3
• 2,5
• 2
• 1,5
• 1
• 0,5

0,5 1 1,5

VA in logMAR

BINOCULAR MONOCULAR

0.3 logMAR or better between +1.00 and -2.50 D (Binocular)

Provisus Research Institute

Halo & Glare Strength

Halo & Glare simulator (Carl Zeiss Meditec, Germany).

• Halo:
• Type: H2
• Size: 58
• Intensity: 69
• Glare:
• Type: G2
• Size: 70
• Intensity: 44

Strength= 63.26% (Moderate) Calculated using the Strength Formula (P.Hagen et al, Düsseldorg, Germany)

Provisus Research Institute

HD Analyzer: Objective Scattering index

OSI MTF cut off (c/deg) Strehl ratio OD 0.4 46.263 0.233 OS 0.5 49.239 0.222

• OSI: Objective Scattering Index: Light

scattering

• MTF cutoff: Modulation transfer function

cutoff: Loss of contrast

• Strehl Ratio:Optical Quality
• Theoretical best value = 1
• Max normal value in a young eye ~ 0.3

Provisus Research Institute

McAlinden Questionnaire

• Halo, Glare and Starbust:
• How often do you experience..?: Quite Often.
• How severe is..?: Moderate.
• How bothersome is..?: A little (Halo), quite

bothersome (Glare and starbust).

• No focusing difficulties!
• If you had to choose again, would you pick

a multifocal intraocular lens again? YES

Provisus Research Institute

McAlinden Questionnaire Spectacle independancy

Did the Surgery offer you spectacle independency? In all Distances: Far, Intermediate and Near

Provisus Research Institute

Conclusion

• The new EDOF AT LARA 829MP offers a new range of

individualized care.

• It allowed in this hyperopic patient an excellent visual restoration

in all distances due to the Extended range of focus with excellent VA in Far, Intermediate and Near distances.

• Spectacle independence and satisfaction from the surgery and the

choice of the IOL.

• Persistence of photic phenomena without impact on daily life.
• Good optical quality.

Thank you very much for

Your Attention!

Augenärzte

Gerl, Kretz & Kollegen

• Dr. med. Florian T. A. Kretz, FEBO

CEO – Share Holder – Lead Surgeon Augentagesklinik Rheine - Greven Email: f.kretz@augenklinik.de Tel.: +49-2561-9555675 Head Office Am Schloßgraben 13 48683 Ahaus Germany

Provisus Research Institute

Follow us on

@drkretz @KretzDr