THE ULTIMATE ACCURACY

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Emmeline Randall
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2 THE ULTIMATE ACCURACY ACHIEVING EMMETROPIA IS THE GOAL OF MODERN CATARACT SURGERY Ametropia of 0.25 D causes the loss of one line of visual acuity and ametropia of 0,50 D causes the loss of two lines of visual acuity. THE MTO INTRAOCULAR LENSES HAVE A PRECISION AND VARIATION STEP OF ONLY 0.01 D, IN ORDER TO OPTIMIZE REFRACTIVE RESULTS. Clinical studies show the value of this new standard: 93% of eyes implanted with an MTO IOL have residual ametropia of less than or equal to 0.50 D. However, only 63% of patients who undergo cataract surgery have post-operative refraction of less than or equal to 0.50 D 1 (standard IOL with no variation in optical power of 0.50 D). Inaccurate measurements (axial length and keratometry) and calculation formulae are not the only causes. The lack of precision in the IOL power is another important cause. Indeed, there is a tolerance in the manufacturing process of around ±0.40 D, or even more depending on the Powers 2. Standard IOL Softech HD IOL, WHY MUST WE GET CLOSEST POSSIBLE TO EMMETROPIA? WITH PRESBYSMART CRYSTAL IOL, THE PREDICTABILITY OF CATARACT SURGERY IS MOVING CLOSER TOWARDS THAT OF CORNEAL LASER SURGERY. Nom: Né(e) le : Date d examen : AL : 23,07 mm KI : 43,57 dpt x 30 K2 : 44,15 dpt x 120 Opt ACD : Numéro ID : Oeil chirurgien : SRK/T Formule : Données préopératoires : Réfraction : OD Acuité visuelle : Phaque droit Statut de l oeil : plan Réfraction souhaitée : MTO A Const : IOL (D) REF (D) IOL émmé. : SPHERICAL CORNEAL ABERRATION VS REFRACTIVE ACCURACY Point spread function (PSF) in 3D, quality of vision and convolution with a lethers chart in a case of emmetropia (left) and defocus of 0.50 D. Pupil of 6 mm SA = 0,173 micron SA < 0,10 D (1)Thomas Olsen. Improved accuracy of intraocular lens power calculation with the ZEISS IOL Master. Acta ophtalmol Scand. 2007:85:84-87 (2)Kenneth J Hoffer et al. testing the dioptrie power accuracy of exact-power labeled intraocular lens. J cataract Surg 2009;35: ASCRS AND ESCRS. (3) why should a surgeon work to get better outcomes-aren t most cataract outcomes good enough? by Lenstec company in USA 2010.

3 PROVEN TRIFOCAL CLINICAL STUDIES SHOW AN OPTIMAL VISION AT ALL DISTANCES: Far because of its refractive precision Near because of its optical quality Intermediate because of the design of the diffractive side. AN INNOVATIVE DIFFRACTIVE SIDE UNIQUE ASPHERICITY FOR GREATER VISUAL COMFORT A unique combining the benefi ts of a and negative. The of crystal evolution IOL ensures greater depht of fi eld while maintaining quality of vision compared to an IOL with a negative Addition is not constant over the entire surface of the lens, but decreases from the center towards the periphery. For this reason, the intermediate vision, the average power of the addition becomes weaker than that of near vision, due to the concomitant dilation of the pupil. IDEALLY SHARP FOCUS - IOL With negative. good depth of field +3.0 D D (unique ) IDEALY SHARP FOCUS Monocular Binocular AS A RESULT, INTERMEDIATE VISION IS GREATLY IMPROVED COMPARED TO CONVENTIONAL DIFFRACTIVE IOL. Uncorrected visual acuity after 3 months with the IOL. UVCA (decimal) (logmar) , ,10 0-0,5-1 -1,5-2 -2,5-3 -3,5-4 Refraction (D) DEFOCUS CURVES OF PRESBYSMART , , , , , ,50 ADD +3.5 D ADD +3.0 D BINOCULAR ,60 FAR VISION 100 cm 70 cm 50 cm 40 cm 33 cm COMPUTEUR READING Distance of vision

4 THE ONLY IOL WITH GUARANTEED OPTICAL QUALITY TODAY, IT IS NOT ENOUGH JUST TO GIVE GOOD VISUAL ACUITY TO PATIENTS UNDERGOING CATARACT SURGERY THE QUALITY OF EACH PRESBYSMART CRYSTAL EVOLUTION IS CONTROLLED BY THE «US AIR FORCE» RESOLUTION TARGET* A good quality of vision is also important for patient satisfaction, and to reduce side effects of optic. THE FIRST STEP TOWARDS IMPROVING QUALITY OF VISION IS TO ENSURE THE HIGHEST QUALITY OF THE IOL. Optical quality is measured by analyzing the modulation transfer function (MTF). The higher the optical quality, the closer the value is to1 (100% transfer of contrasts by the optic analyzed). THE OPTICAL QUALITY OF EACH PRESBYSMART CRYSTAL EVOLUTION IS NOT ONLY VERY HIGH, BUT ALSO GUARANTEED BY THE MTF CURVE DELIVERED IN EACH BOX. High resolution picture of the test lines Low resolution picture of the test lines It is shown in relation to the real power of the IOL for near focus and for far focus. A color chart showing power (D) is also provided for each. It is also possible to check addition power. THE PRESBYSMART CRYSTAL EVOLUTION IOL OPTIMIZES POSTOPERATIVE QUALITY OF VISION... An OQAS II analysis of patients operated on using IOL from the range shows a very high quality of vision, similar to that of young emmetropic patients. MTF cut off (c/deg) : Strehl ratio : Astigmatism axis (deg) : 17 Profile angle (deg) : 0 Width at 50 % (a rc min.) : 2.47 Width at 10% (ar c min.) : VA 1.72 C = 100% VA OQAS Value Mean Contrast C = 20%C = 9% VA 0.85 An OQAS II analysis of quality of vision carried out on a patient three months after a cataract operation with a IOL. *MTO GUARANTEE THE OPTIC OF OUR LENSES THEY UNDERGO TWO STRINGENT TESTING, THE MTF CURVE AND THE «US AIR FORCE» RESOLUTION TARGET. *Depending on availability

5 CHARACTERISTICS 70µ 6,0 6,0 13,0 13,0 profi le Characteristics SMARTIOL CRYSTAL EVOLUTION PRESBYSMART CRYSTAL EVOLUTION Material Optic design Optical diameter Overall diameter Angulation Additions for new vision * Haptic design Sterilization Specification Theoretical AC Depth ** Refraction index Monofocal single piece, equi-biconvex, square-edged, negative Models Hydrophobic acrylic with UV Filter and Yellow Filter Multifocal single piece, equi-biconvex, square-edged, negative +3.0 D and +3.5 D Square-edge haptics modified C Loop Diopters available * From +6.0D to +30.0D Increment From +10.0D to +30.0D Increment Acoustic Biometry (Ultrasounds): A constant (estimate) ** Optical Biometry (IOL Master): mm 13 mm 0 Ethylene Oxide (ETO) Preloaded system (2.2mm) 3.80 mm 1.49 * Depending on availability. ** Constant A and AC Depth are estimated values. Each surgeon is recommended to adjust these values. AN INTUITIVE AND SIMPLIFIED INJECTION BY MINI-INCISION (2.2 mm) The new injection system only needs 2 steps before implanting. 1 st Step: Close the cartridge VIOLET LIGHT FILTER In addition to a UV fi lter, the also includes a yellow chromophore. Its very low concentration ensures the blocking of high energy violet wavelength, which is the most toxic for the retina. However blue light is not fi ltered. The light absorption spectrum is thus closed to that of the lens of a young adult. This is important when it comes to maintaining a good degree of contrast sensitivity in scotopic vision (where blue light represents 35% of the spectrum) and preserving cicardian rhythm. 2 nd Step: Apply viscoelastic from the front barrel of the cartridge

6 MTO Micro Technologie Ophtalmique SA Place de la Gare SION - Switzerland info@mto-ophtalmo.ch

7 Hydro PHOBIC Hydro PHILIIC Hydro PHOBIC Hydro PHILIIC PRELOADED A.POWER : Accurate Power : e.g. : 20.31D R.POWER : Rounded Power : e.g. : 20.50D REF NAME DESCRIPTIF DIOPTERS ADDITION CONSTANT PCE1 PCE2 SCE Smartiol Multifocal yellow preloaded Monofocal yellow preloaded NON-PRELOADED D to D ADD +3.50D ADD +3.00D D to D Constante A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.01 HOLLADAY 1/SF 1.25 HAIGIS/ A0: A1: A2: ACD Ultrasound: 3.80 Constante A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.51 HOLLADAY 1/SF 1.74 HAIGIS/ A0: 1.30 A1: 0.4 A2: 0.1 ACD Ultrasound 3.80 A.POWER : Accurate Power : e.g. : 20.31D R.POWER : Rounded Power : e.g. : 20.50D REF NAME DESCRIPTIF DIOPTERS ADDITION CONSTANT PPE1 PPE2 SPE PPE SCRY PSP0 PSP1 PSP2 SIP Smartiol Smart.iol Smartiol Multifocal yellow lens Monofocal yellow lens Multifocal yellow Monofocal yellow Multifocal lens Multifocal lens Multifocal lens Monofocal lens D to D ADD +3.50D ADD +3.00D D to D D to D ADD +3.25D D to D D to D ADD D ADD D ADD D From D to D of 1.0 D From D to D of 0.01 D Constante A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.01 HOLLADAY 1/SF 1.25 HAIGIS/ A0: A1: A2: ACD Ultrasound 3.80 Constante A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.01 HOLLADAY 1/SF 1.25 HAIGIS/ A0: A1: A2: ACD Ultrasound 3.80 Constante A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.70 HOLLADAY 1/SF 1.94 HAIGIS a0 : 2.17 / a1 : 0.30 / a2 : 0.09 ACD Ultrasound 5.10 Constante A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.70 HOLLADAY 1/SF 1.94 HAIGIS a0 : 2.17 / a1 : 0.30 / a2 : 0.09 ACD Ultrasound 5.10 Constant A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.17 HOLLADAY 1/SF 1.39 HAIGIS/ A0: A1: 0.4 A2: 0.1 ACD Ultrasound 4.80 Constant A : US / IOL MASTER SRKT SRKII HOFFER Q /Pacd 5.17 HOLLADAY 1/SF 1.39 HAIGIS/ A0: A1: 0.4 A2: 0.1 ACD Ultrasound 4.80 MTO Micro Technologie Ophtalmique SA Place de la Gare SION Switzerland Phone : info@mto-ophtalmo.ch Web :

Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator

Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator Sahiba K Chailertborisuth, Saneha K. C. Borisuth, Navaneet S.C. Borisuth, MD, PhD Virdi Eye Clinic & Laser Vision