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Getting Started With Alcon PCIOLs

Farrell C. Tyson, MD, FACS; David Stephens, MD; and Cristos Ifantides, MD, share insights into how surgeons can get started using presbyopia-mitigating IOLs. They explain that the best way to gain comfort with the technology is to select the ideal patient candidates, ensuring great results and boosted confidence. Advances in lens material and IOL calculation formulas allow for highly successful outcomes. Dr. Tyson says, to get started, surgeons should keep it simple with patient selection, achieve great outcomes, and grow patient selection candidates as comfort builds.

IMPORTANT PRODUCT INFORMATION

CLAREON^® FAMILY OF IOLS

CAUTION: Federal law restricts these devices to sale by or on the order of a physician.

INDICATION: The family of Clareon^® intraocular lenses (IOLs) includes the Clareon^® Aspheric Hydrophobic Acrylic and Clareon^® Aspheric Toric IOLs, the Clareon^® PanOptix^® Trifocal Hydrophobic IOL, Clareon^® PanOptix^® Toric, Clareon^® Vivity^® Extended Vision Hydrophobic Posterior Chamber IOL and Clareon^® Vivity^® Toric IOLs. Each of these IOLs is indicated for visual correction of aphakia in adult patients following cataract surgery. In addition, the Clareon^® Toric IOLs are indicated to correct pre-existing corneal astigmatism at the time of cataract surgery. The Clareon^® PanOptix^® lens mitigates the effects of presbyopia by providing improved intermediate and near visual acuity, while maintaining comparable distance visual acuity with a reduced need for eyeglasses, compared to a monofocal IOL. The Clareon^® Vivity^® lens mitigates the effects of presbyopia by providing an extended depth of focus. Compared to an aspheric monofocal IOL, the lens provides improved intermediate and near visual acuity, while maintaining comparable distance visual acuity. All of these IOLs are intended for placement in the capsular bag.

WARNINGS/PRECAUTIONS:

General cautions for all Clareon^® IOLs: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting any IOL in a patient with any of the conditions described in the Directions for Use that accompany each IOL. Physicians should target emmetropia,and ensure that IOL centration is achieved.

For the Clareon^® Aspheric Toric, PanOptix^® Toric and Vivity^® Toric IOLs, the lens should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary, lens repositioning should occur as early as possible prior to lens encapsulation.

For the Clareon^® PanOptix^® IOL, some visual effects may be expected due to the superposition of focused and unfocused multiple images. These may include some perceptions of halos or starbursts, as well as other visual symptoms. As with other multifocal IOLs, there is a possibility that visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. A reduction in contrast sensitivity as compared to a monofocal IOL may be experienced by some patients and may be more prevalent in low lighting conditions. Therefore, patients implanted with multifocal IOLs should exercise caution when driving at night or in poor visibility conditions. Patients should be advised that unexpected outcomes could lead to continued spectacle dependence or the need for secondary surgical intervention (e.g., intraocular lens replacement or repositioning). As with other multifocal IOLs, patients may need glasses when reading small print or looking at small objects. Posterior capsule opacification (PCO), may significantly affect the vision of patients with multifocal IOLs sooner in its progression than patients with monofocal IOLs.

For the Clareon^® Vivity^® IOL, most patients implanted with the Vivity^® IOL are likely to experience significant loss of contrast sensitivity as compared to a monofocal IOL. Therefore, it is essential that prospective patients be fully informed of this risk before giving their consent for implantation of the Clareon^® Vivity^® IOL. In addition, patients should be warned that they will need to exercise caution when engaging in activities that require good vision in dimly lit environments, such as driving at night or in poor visibility conditions, especially in the presence of oncoming traffic. It is possible to experience very bothersome visual disturbances, significant enough that the patient could request explant of the IOL. In the parent AcrySof^® IQ Vivity^® IOL clinical study, 1% to 2% of AcrySof^® IQ Vivity^® IOL patients reported very bothersome starbursts, halos, blurred vision, or dark area visual disturbances; however, no explants were reported.
Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon informing them of possible risks and benefits associated with these IOLs.