enVista (hydrophobic acrylic intraocular lens) is a premium monofocal intraocular lens (IOL) that delivers superb visual acuity, consistent performance, and outstanding patient outcomes without glistenings.1

Glistenings Do Not Occur with enVista

Dr. Mitchell Shultz is board certified and a fellow of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery. He has been implanting enVista lenses since the lens first became available in the United States. 

Dr. Shultz noted that “from the time enVista lenses were implanted almost ten years ago, the lenses remain clear. This is a big advantage over lenses that can develop glistenings over time.”

Glistenings are fluid-filled microvacuoles that are primarily associated with hydrophobic acrylic IOLs, but do not occur with enVista.2 Glistenings vary in size and start to appear anywhere from a few months to years after surgery.2 Glistenings are a common post-operative occurrence and seem to increase over time in blue light–filtering specific hydrophobic acrylic IOLs.3

Several clinical issues can occur in eyes that have developed glistenings. These issues include complaints of poor vision despite satisfactory or normal visual acuity; development of poor vision quality in patients who also have decreased visual acuity and/or contrast sensitivity; and decrease or loss of the lenses special function. In some cases, an additional surgery is necessary for explantation or exchange of the IOL.4 By contrast enVista is a glistenings free IOL.

enVista Balances Depth of Field and Image Quality4

The enVista lens is spherically neutral so the surgeon is counting on the patient’s natural corneal spherical aberration to achieve depth of field. Lenses with negative spherical aberration treatments lose the depth of field to enhance contrast sensitivity. These lenses reduce the eye’s natural spherical aberration which thereby reduces the depth of field. enVista allows him to give everyone excellent quality of vision.

Image Quality and DOF for various amounts of SA

enVista Is Aberration Free

enVista features an aberration-free optic that provides a desirable balance of image quality and depth of field.1 The uniform power from center to edge, compensates for slight optic tilt and decentration.4

If decentration occurs, other aberrations can degrade retinal image quality.5 The enVista IOL is less affected by decentration in comparison to negatively aberrated IOLs.

Dr. Shultz believes the benefit of an aberration-free IOL is that “if a patient’s line of sight is not through the center of the lens, their quality of vision is still excellent.” Before he switched to the Bausch + Lomb platform, Dr. Shultz was using a lens with negative spherical aberration. He noticed that in hyperopic patients, tolerance for any refractive error was extremely small. His hyperopic patients would complain about decreased quality of vision with slight myopic postoperative refraction of -0.25D to -0.50D. With enVista, he doesn’t see the drop-off in vision. Extra care needs to be taken during a postoperative refraction in order to find the middle of the visual range and optimize the postoperative spectacle prescription.

Dr. Shultz has seen less capsular contraction in eyes implanted with enVista IOLs. He attributes this to the fact that enVista is 300% more resistant to compression vs traditional hydrophobic acrylic platforms and that the haptics are more rigid, providing more support to the lens capsule.6 Thus, enVista helps reduce compressive forces and keep the lens in position.

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