In a recent conversation, Dr Epitropoulos discussed her experience with the Apthera lens and a recent case of a patient with low astigmatism.
Preoperative Conversations With Patients
“It’s important to have a conversation with patients about the technologies that are available, whether they are a candidate or not. I may explain, ‘There are upgraded lenses out there that give a range of vision, but you are not a candidate for this technology.’1 We also want to communicate realistic expectations and that we’ll look at the best IOL option to fit their wants and needs. It’s important to set realistic expectations and educate them that a lot goes into what their outcome may be. Under promise, over deliver.”
Patient Selection Process
“A candidate for the Apthera lens has healthy eyes that dilate to at least 7.0 millimeters and has expressed an interest in reducing dependence on corrective lenses. Patients with a small amount of astigmatism – up to 1.5 D – are also excellent candidates for this technology. The Apthera lens is implanted in the non-dominant eye."
Patient Case 1
“I had a patient with low astigmatism who wore bifocals most of the time. He presented with complaints of blurred vision, difficulty following the golf ball, difficulty reading books and the computer screen, and glare and halos at nighttime. He was diagnosed with visually significant cataracts in both eyes.”
MTF Measurements for 6 IOLs2
This graph presents MTF image quality measurements for six IOLs. The image quality is measured by the area under the curve. The higher the peak the better the image quality at that focal point.
“We discussed lens options and he was not interested in multifocal technology due to the potential for glare, halos, or starburst at night. I told him that if he wanted more range of vision, he might want to think about a premium presbyopic lens with an extended depth of focus.”1
“For his nondominant eye, I told him that there is a new technology – the IC-8 Apthera lens – with a pinhole optic that offers patients distance, intermediate, and up-close vision.1,3 Additionally, in the Apthera clinical study, 80% of patients reported none to mild glare and halos 12 months after implantation.1 The lens is indicated for primary implantation in the nondominant eye.1 For this patient, he had a history of dry eye, which we treated preoperatively, to get the most accurate measurements.”
“We decided on the enVista® toric to correct the small amount of against-the-rule astigmatism in his dominant eye, and Apthera in his nondominant eye.”
“At the two-week mark, he said that he did notice some glare and halos at night. But a week later, that problem had been resolved. This has been my experience with another patient as well.”- Alice Epitropoulos, MD
“My typical refractive target for the Apthera IOL is between minus 0.75 and minus 0.9. That’s the sweet spot. At two weeks out after implantation of the IC-8 Apthera, he was 20/20 at distance, 20/10 at intermediate, and J1 + for reading. At all distances, he was 20/20 or better, and he said, 'This is the best I've seen in a long time.' He's ecstatic with his results. He doesn’t need prescription glasses for reading. He told me, ‘I can read almost anything!’ His night vision is quite a bit better, and his outdoor vision is phenomenal.”
“He said, ‘My vision is great! Things are clearer, brighter, and crisper.’ That 'wow factor' is very important. We're doing this to help our patients, and we want them to be happy. His outcomes exceeded both of our expectations.”
“At the two-week mark, he said that he did notice some glare and halos at night. But a week later, that problem had been resolved. This has been my experience with another patient as well.”
“Premium lenses provide the surgeon the ability to help a patient get back to a more active lifestyle – possibly even resuming activities that they previously had to give up because of the cataract. This patient said, ‘I’m excited that I am able to get back on the golf course. I’ve noticed an improvement in the contrast, and the contour on the green.’ The main objective for performing cataract surgery is to help patients resume daily activities and get back to the quality of life they want. The Apthera technology provides patients the ability to get the range of vision that so many patients love without compromising quality.”
“I’m looking forward to being able to offer this technology to more patients to improve their quality of vision and quality of life.”
Alice T. Epitropoulos, MD, FACS is a board-certified ophthalmologist who specializes in refractive and cataract surgery in Columbus, Ohio and is affiliated with multiple hospitals in the area, including the Ohio State University Wexner Medical Center. She is a founding member of The Eye Center of Columbus, an affiliation of more than 80 ophthalmologists in downtown Columbus. She received her medical degree from and completed her residency in Ophthalmology at the Ohio State University College of Medicine, where she is now Clinical Assistant Professor.
Financial disclosure: consultant to Bausch + Lomb