Karolinne Maia Rocha, MD, PhD, is a cataract, cornea, and refractive surgeon with expertise in adaptive optics, notably characterizing the exact amount of higher-order aberrations that balances depth of focus with quality of vision.
Dr. Rocha explained that “The enVista IOL platform has great lenses for eyes that are not perfect because it is aberration-free. enVista is very forgiving.” She also discussed the benefits of enVista in normal eyes.
enVista is aberration-free with uniform power throughout the lens
Dr. Rocha values the optics, design, glistening-free property, and the fact that enVista is aberration-free. enVista keeps the natural corneal aberration. However, enVista keeps the NATURAL corneal positive spherical aberration of the eye INTACT, which may allow extended depth of focus.1 Conversely, in patients with negative corneal SA, implanting a lens with additional negative SA can further detract from achieving the best-corrected visual acuity. Thus, enVista, which is spherically neutral, is preferred.
enVista is an advanced, defocus-tolerant, aberration-free premium monofocal IOL. enVista is less sensitive to decentration when compared to negatively aberrated IOLs.2 Thus, with enVista, image quality degradation is decreased as there is a reduction in potentially inducing optical aberrations, especially in aberrated eyes.2
Aberration-free IOLs like enVista induce significantly less aberrations resulting in degradation of retinal images unlike Acrysof IQ and Tecnis monofocals.2
enVista is glistening-free
Glistenings are an unfortunate occurrence in the months and years following IOL insertion with some lens types and can reduce vision quality.3 With the enVista platform of glistening-free lenses, patients maintain visual clarity over time.3,4
enVista for post-hyperopic LASIK
In Dr. Rocha’s experience, enVista is an extremely important lens for patients with post-hyperopic LASIK. After hyperopic LASIK, patients present with hyper-prolate corneas and negative SA. In this type of patient, it is extremely important to use an aberration-free lens, so aberration is not added to the optical system.5 “enVista is my go-to lens for post-hyperopic LASIK patients,” per Dr. Rocha. enVista toric is a great lens for post-hyperopic LASIK because it does not add to the negative spherical aberration.
enVista can be used in various patient types
enVista is an advanced aberration-free hydrophobic acrylic IOL that provides a balance between depth of field and image quality.6 enVista has uniform power center-to-edge. Because enVista has uniform power throughout the lens, it is able to compensate for common levels of decentration.6
enVista is appropriate for a variety of patients that will undergo cataract surgery due to its unique optic characteristics. While “enVista performs extremely well in normal eyes,” according to Dr. Rocha, she also appreciates the benefits of the enVista aberration-free lens in more challenging scenarios including:
- Post-hyperopic LASIK
- Negative spherical aberration
- Irregular astigmatism
- Higher order aberrations (including coma, trefoil)
- Corneal ectasia
enVista toric IOL for astigmatism
enVista toric is a great option for patients with astigmatism. The enVista toric IOL is rotationally stable because it has 110 degrees of contact to the capsular bag.2 This reduces the amount of IOL rotation post-operatively and provides reliable astigmatism correction with outstanding patient outcomes.7 In Dr. Rocha’s experience, it is “extremely rare for the enVista toric IOL to rotate after surgery.”
The enVista toric is available in a low-power lens; it is the only platform in the US that corrects less than 1 diopter of astigmatism at the corneal plane, which is very helpful for patients with lower amounts of astigmatism.8 A toric IOL is more precise than a limbal relaxing incision (LRI). Dr. Rocha uses the 1.25 diopter enVista toric often and notes that her standard monofocal to toric IOL conversion rate is higher because of the availability of the lower power model.
enVista offers a balance between image quality & depth of focus
Patients can tolerate their naturally occurring residual SA when implanted with an aberration-free IOL. When we look at the depth of focus curve in a model cornea, it is wider with enVista than with a lens with negative spherical aberration.5,6 Implanting enVista, patients can achieve the benefits of a premium monofocal lens, with excellent distance vision, with a lens that has a balance of depth of focus and vision quality.
*Bench study of focus images under mesopic conditions using a model cornea with spherical aberration of 0.27 μm over 6.0mm.
“I am very happy with the outcomes in my patients when I use the enVista IOL platform. The distance vision is excellent. Patients have a tolerance to some residual astigmatism, so they do really well with the image quality.”- Dr. Karolinne Maia Rocha
Karolinne Maia Rocha, MD, PhD, is an Associate Professor of Ophthalmology and Director of the Cornea & Refractive Surgery program at the Medical University of South Carolina, Storm Eye Institute in Charleston, South Carolina. Dr. Rocha is active in clinical research and has published over 100 scientific works. She published one of the first clinical applications of adaptive optics characterizing the exact amount of higher-order aberrations that balances depth of focus with quality of vision.
Financial disclosure: consultant to Bausch & Lomb