Ahad Mahootchi, MD, is an ophthalmologist and cataract surgeon at The Eye Clinic of Florida who has performed more than 25,000 eye surgeries. Over the past 18 years, he has inserted Crystalens® AO or Trulign® lenses in more than 2500 patients. Dr. Mahootchi discussed several reasons he uses Crystalens®.
Crystalens® AO is the only US Food and Drug Administration (FDA)-approved accommodating intraocular lens (IOL) on the market with a low risk of positive dysphotopsias. Crystalens® also generates fewer halos compared with multifocal and monofocal IOLs, because it has one distinct point of focus and changes position and functional power within the capsular bag to deliver clear vision with minimal halos and glare.1,2,3
Long-term advantages of Crystalens®
Dr. Mahootchi noted that Crystalens® is a forgiving lens. The accommodating technology provides continued good eyesight. For Dr. Mahootchi, his Crystalens® patients have been able to continue without the need of glasses with little to no refractive drift.
Another reason Dr. Mahootchi chooses accommodating IOLs vs traditional multifocal IOLs is the reduction of contrast sensitivity.4 Accommodative IOLs will not induce a loss of contrast sensitivity in this patient population.5
Dr. Mahootchi observed nearly 1000 postoperative Crystalens® or Trulign® patients for more than 10 years. The patients received a refractive eye exam in his office annually. Over the 10 years, the average hyperopic drift was only 0.25 diopters. More than 95% of the patients remained glasses independent for distance and intermediate vision. Around two-thirds of patients remained glasses independent for near vision.6
“For my patients with active lifestyles that benefit from excellent contrast sensitivity, I go with accommodating IOLs. Crystalens® is my accommodating IOL of choice.”- Ahad Mahootchi, MD
Mixing and matching lenses
Typically, Dr. Mahootchi operates on the nondominant eye first. Some patients want a trifocal in the first eye they have cataract surgery on. At follow-up, Dr. Mahootchi finds these patients are often happy with the near vision results, but the distance vision is suboptimal, and they may experience bothersome side effects such as halos and inability to drive at night. In these situations, he suggests Crystalens® for the dominant eye. Patients are really happy with Crystalens® in the dominant eye because they have the distance vision they want, they can drive and see clearly at night, and they have enough near vision with the trifocal in the nondominant eye for reading and other close tasks. The combination of Crystalens® in the dominant eye and a trifocal IOL in the nondominant eye provides patients with good near, intermediate, and distance vision.
Traditional trifocal IOLs have been shown to have issues with contrast sensitivity, glare and halo.7 Dr. Mahootchi has patients with active lifestyles, and finds that accommodating IOLs fit best with these active lifestyles.
Dr. Mahootchi bases the decision of what type of premium IOL to recommend on whether near vision or night vision is more important for the patient. If night vision is more important, he opts for Crystalens® or Trulign®.
Polishing the capsular bag makes a difference
According to Dr. Mahootchi, “When you’re doing cataract surgery, it’s worth the effort to clean up the bag. If you polish the bag, you remove more material than when you just use irrigation and aspiration.”
As part of cataract surgery, Dr. Mahootchi uses trypan blue to kill the remnant lens epithelial cells. He leaves the trypan blue in the eye for about a minute, inflates the bag with viscoelastic, and then polishes the capsule with a double-ended polisher. He uses a ring on one side to get below the capsule and clean subincisional material. After he polishes, he puts the lens in. Since he started using this technique, he has noticed that his refractive results have improved. When he used trypan blue, up to 2 years following cataract surgery, less than one-third of these patients needed a YAG capsulotomy.
Even when implanting a multifocal IOL, Dr. Mahootchi uses trypan blue to help polish the bag. By cleaning up the bag during the initial procedure, it makes it easier to remove a lens later, if necessary.
Crystalens® has a unique, spherical aberration-neutral design
Crystalens® is a spherically neutral, aberration-free lens, with uniform power across the lens.1 It provides exceptional contrast sensitivity by focusing 100% of light, 100% of the time.2,8 The neutral asphericity makes Crystalens® more forgiving of higher-order aberrations, coma, and the natural decentration that occurs over time.
Ahad Mahootchi, MD, is a board-certified ophthalmologist and founder of The Eye Clinic of Florida. He attended Vanderbilt University School of Medicine and completed his residency there. He has been in practice for more than 24 years.
Financial disclosure: Consultant to Bausch + Lomb