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Archive July 2020 XXI, No. 7

6 Exciting Developments in Cataract Surgery

These neat new innovations could propel the specialty to new heights.

T. Hunter Newsom

T. Hunter Newsom, MD


This was shaping up to be another great year for eye surgery centers until COVID-19 closed OR doors on elective cases. Not only did we lose business, but we also were deprived of the annual American Society of Cataract and Refractive Surgery (ASCRS) meeting, at least in person. The quickly assembled virtual conference was as good as could be expected, but I really missed the in-person aspect.

I like to go to ASCRS to sit down with my peers, have some dinner and a drink or two, and talk about the latest trends in cataract surgery. "What are we doing? What's really working? What's the next big thing?" It's good for us to hear from other surgeons about how products really work, or new things we should try. I might not have been able to discuss innovative ideas over a porterhouse and Cab Sav, but I've remained connected enough to know some compelling products have emerged in the cataract space. Let's talk about them. OSM


Alcon | AcrySof IQ Vivity IOLs

The Vivity is the first-of-its-kind presbyopia-correcting intraocular lens (PC-IOL), available in spherical and toric versions. Other PC-IOLs haven't taken off because they focus "distance" and "near" vision simultaneously by interrupting the wavefront of light. That means patients will see rings and halos at night, and that's a concern for many people. For correcting presbyopia, surgeons also have the option of implanting monovision IOLs (one eye "distance," one eye "near"), which have their own limitations. The Vivity IOLs, with their non-diffractive design, provide an increased depth of focus and extended range of vision, while largely eliminating the rings and halos. My facility was involved in the FDA studies for this innovative lens, and last month we became the first practice in the country to implant the toric version. I'm excited about this product and think it's going to be a hit, especially with cataract patients who do a fair amount of night driving.


FCI Ophthalmics | Morcher EyeJet Type 15 CTR

Capsular tension rings allow surgeons to stabilize the patient's capsular bag, which is delicate. An increased angle of attack on the leading edge of the ring — referred to as a "gentle elbow" — reduces the resistance and allows for a smoother injection. This reduces the risk of snagging a loose bag or potentially puncturing the capsule. Like the company's previous rings, this one also comes in three different sizes. The preloaded disposable injector eliminates the headache of manually loading a CTR.


EyePoint Pharmaceuticals | Dexycu

It's generally accepted that cataract patients don't like postoperative steroid drops, which can lead to compliance problems. That's why injectable anti-inflammatory drugs like this one that reduce or remove the need for drops are of great interest. At virtual ASCRS, EyePoint presented positive retrospective case study data supporting Dexycu. They also seized on the COVID-19 issue by pointing out the drug can reduce follow-up clinic visits and thus limit physician and caregiver contact. Like many things during this volatile time in surgery, this drug is moving from a nice-to-have to a must-have for many ophthalmologists.


Johnson & Johnson Vision | TECNIS Multifocal Toric II Intraocular Lens

This is the first multifocal IOL on J&J's new Toric II Platform with astigmatism correction capabilities. The fact that these popular multifocal lenses now come in toric versions is a big plus. It provides another avenue to correct both cataracts and astigmatism during the same procedure. This product also features increased friction and surface texture on its haptics, which provides rotational stability. That's important because the quality of refractive and astigmatic correction can decrease if alignment of the lens is off by as little as six degrees. Now that the outside of this square-edge lens is a bit stickier due to its new "frosted haptics" design, there's more friction between the haptics and the capsular bag, so it doesn't rotate after implantation.

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