Novel IOL provides promising results in small series

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A novel multifocal IOL with a unique axiconic-like shape changes a ray of light into a focal line and provides patients with an extended depth of focus.

Dr. Blondel

By Cheryl Guttman Krader; Reviewed by Jérôme Blondel, MD

Onex, Switzerland-Results of a prospective clinical trial provide evidence that a novel, microincision, acrylic multifocal IOL (InFo, Swiss Advanced Vision) achieves its goal of providing continuous good vision, said Jérôme Blondel, MD.

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“The name of this IOL, InFo, was chosen to reflect that it provides an invariant focus,” said Dr. Blondel, head physician, Clinique de l’Oeil, Onex, Switzerland. “Based on its design and our early clinical outcomes, we believe that it is not just another multifocal IOL, but rather represents an important step forward in the management of presbyopia after cataract surgery.

“However, more data and longer follow-up are needed to understand the efficacy and safety outcomes, including the development of capsular opacification,” he said. “A multicenter study is under way.”

In contrast to other multifocal IOLs that transform an incoming light ray to two or three focal points by virtue of their bifocal or trifocal design, the new implant has a unique axiconic-like shape that changes a ray of light into a focal line. It thereby provides patients with an extended depth of focus, similar to what is achieved with the natural process of accommodation (~3 D).

The novel optic design also reduces the potential for glare and halos, which are associated with conventional diffractive multifocal optics.

Outcomes after implantation

Dr. Blondel presented outcomes after implantation of the axiconic-like multifocal IOL in four patients. Three patients underwent bilateral surgery and the fourth patient, who was amblyopic in one eye, had the IOL implanted only in the fellow eye. All surgeries were performed through a 2-mm incision. All patients were seen at 1 month, and the first patient with the implant was evaluated at 1 year.

Refractive outcomes at 1 month ranged from 0 to 0.5 D, Dr. Blondel said.

Visual acuity testing showed binocular and monocular distance uncorrected visual acuity of 10/10. All patients had 10/10 binocular uncorrected intermediate visual acuity measured at 60 cm, while binocular uncorrected near visual acuity was P2. Only one patient reported using glasses occasionally and only for a specific near task (when knitting for more than 30 minutes). Defocus curve testing performed at 1 year after surgery in the first patient demonstrated excellent results over the distance to near range.

There were no intra- or postoperative complications; no patients complained of glare or halos; and the patients expressed high satisfaction with their outcomes. All four patients said they would recommend the surgery to a friend or family member and that they would undergo the procedure again.

The lens is made of a clear hydrophilic acrylic material (26% water content). It has a square edge, 6-mm optic with an aspheric-front surface. The haptics have a multilink design with four-point attachment and no angulation.

The InFo IOL has the CE Mark but is not approved by the FDA. A toric version is anticipated and new packaging is being developed.

Jérôme Blondel, MD

E: jblondel@vision.tv

This article was adapted from Dr. Blondel’s presentation at the 2014 meeting of the American Society of Cataract and Refractive Surgery. Dr. Blondel has no relevant financial interest to disclose.