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global experience booth talk STAAR
- 1. Global Experience withEvo Visian ICL and EVO+ Visian ICL Financial disclosure : consultant Staar Surgical, Bausch+Lomb, PhysIOL, Ophtec, Rayner ERIK L. MERTENS MD, FEBOphth. Physician CEO and Medical Director Eye Surgeon Chief Medical Editor JCRSToday STAAR® Surgical EVO Visian ICL® Booth Chicago, USA, October 2016
- 2. Former Indications • thincornea • dry eye • forme fruste keratoconus • myopia > - 6 D • hyperopes
- 3. Indications • every eyesuitable for ICL • unless there is a contra-indication • LASIK and dry eye = dramatic
- 4. ICL-T ICL AGE 30 50 0 Diopters +20-30 -20-6+2+10 LASIK 90 Femto IOL Decision Tree Femto IOL 40 Femto IOL +20 0 -30
- 5. FOCUS ON QUALITYAND COMFORT • smaller wound : 2.6 mm • laser : 8.5 mm = 26.5 mm circumference • less-no dry eye • super HD visual quality • less regression • faster recovery WHAT MADE THAT ALL POSSIBLE ?
- 6. VISIAN ICL EVOCentraFLOW Design Modifications • Penetrating holes + Aquaport in center • Extended Toric alignment markings
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- 9. 1469 EVO implants 306with F-U > 4 years Parameter Mean±SD (range) Age (years) 31.8±7.6 (19 to 45) Sphere (D) -5.97±2.82 (-0.75 to -14.75) Cylinder (D) -0.94±0.87 (0 to -4.25) ACD (mm) 3.24±0.20 (2.80 to 3.71) WTW (mm) 11.93±0.36 (11.00 to 12.70) Scotopic Pupil (mm) 6.30±0.66 (4.5 to 7.75) ECC (cell/mm2) 2421.2±271.2 (2235 to 2690) IOP (mmHg) 13.84±3.38 (8 to 22)
- 10. y = 1.0042x+ 0.0131 R² = 0.9992 -16 -14 -12 -10 -8 -6 -4 -2 0 2 -16-14-12-10-8-6-4-202 Attempted spherical Equivalent (D) AchievedSpherical Equivalent(D) N=306 Predictability
- 11. 0% 30% 1% 8% 61% 1% 28% 1% 8% 61% 1% 28% 1% 7% 62% 3% 30% 1% 7% 59% 0% 20% 40% 60% 80% Gained > 2Gained 2 Gained 1.5 Gained 1 Unchanged %ofEyes Changes in BCVA (lines) N=306 SafetySafety
- 12. -5.23 0.02 0.01 0.010.01 -10.00 -8.00 -6.00 -4.00 -2.00 0.00 2.00 MeanSphericalEquivalent(D) N=306 Stability Follow-up periods (years)
- 13. Evolution towards EVO+ VisianICL V3 no cartridge loading forceps UBM toric ICL V4c EVO+
- 14. Larger Optical Zonein Most Diopters while maintaining the same overall height 5.8 mm 6.1 mm V4c -9.0 D V5 -9.0 D height
- 15. Increased Optical Zone 4.800 5.000 5.200 5.400 5.600 5.800 6.000 6.200 -18.0-15.0 -12.0 -9.0 -6.0 -3.0 0.0 Optic Diameter versus Power V5 V4C5.8 mm 6.1 mm Increased Optical Zone
- 16. In daily life •pupillometry magnifies pupil by 13% • corneal OZ = 1.24 x optical Evo+ diameter -6.0 D EVO+ ICL with 6.1 mm optic covers 6.9 mm pupil 6.1 mm optical diameter = 7.56 mm corneal OZ
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- 19. Cornea and crystallinelens remain untouched • Related issues only for LVC • Dry eye • Ectasia • IOL calculation • HOA and premium IOL implantation
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- 22. Conclusions • The EVO+Visian ICL is safe, effective, and predictable in correcting low to moderate degrees of myopia • Superior HD quality vision • No dry eye issues • Cornea and lens unaltered for future options • Potential complications low in incidence
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