TORIC IOL’S Do we need them? Frank goes frank@goes.be Escrs 2011

TORIC IOL’S OR FEMTOLASIK AS A REDO TOOL OR INCISION MODULATION TRY TO AVOID THE NEED OR A COMBINED APPROACH OF BOTH PRINCIPLES Escrs 2011

SURGERY IOL CHOICE IOL POWER CALCULATION Escrs 2011

OUR EXPERIENCE MOSTLY LASER CORRECTION VISUMAX FEMTOLASIK SINCE 2 YEARS BUT Escrs 2011

-12 SF -4.5 cyl. AXIS 135 OD -11 SF -3.5 cyl.axis 75 OS HOW TO APPROACH CASE I -12 SF -4.5 cyl. AXIS 135 OD -11 SF -3.5 cyl.axis 75 OS Escrs 2011

ARTIFLEX TORIC Escrs 2011

OPHTEC ARTIFLEX TORIC ENCLAVATION NEEDLE AND SPATULA Escrs 2011

ANIMATIE Escrs 2011

VERY HAPPY PATIENT UNCORRECTED OD O.9 20/22 OS O.9 20/22 Escrs 2011

CANDIDATE MULTIFOCAL IOL. CASE. II OD SF+6 cyl -5. 5 axis 85°. 0S CANDIDATE MULTIFOCAL IOL ???????? CASE II OD SF+6 cyl -5.5 axis 85° 0S SF +5.5 cyl -6 axis 95° Escrs 2011

TECNIS MF OO HIGHLY MOTIVATED TO BECOME SPECTACLE FREE Escrs 2011

1. TEMPORAL INCISION PLACEMENT 2. SECOND INCISION OPPOSITE SIDE 3 1.TEMPORAL INCISION PLACEMENT 2.SECOND INCISION OPPOSITE SIDE 3.LARGER INCISION 4.FOLLOWED BY LASIK 00 Escrs 2011

A VERY HAPPY PATIENT SPECTACLE FREE FOR DISTANCE AND FOR NEAR VERY BUSY BUSINESSMAN ON THE PLANE AT LEAST ONCE A WEEK Escrs 2011

CASE III OD +6 CYL -6 AXIS 115 OS +6 CYL -6 AXIS 95 ACRILISA TORIC OD 20.5 +5.5 D OS 20.5 +6.5 D Escrs 2011

CARL ZEISS AT LISA toric 909M World first toric multifocal MICS IOL Flagship product for CZM absolutely unique AT LISA toric 909M combines the excellent optical performance of AT LISA and reliable astigmatsim correction of AT TORBI™ 709M in one iol Carl Zeiss calculates the power of AT LISA toric 909M for optimal surgery outcome Escrs 2011

PREOP PREOP POSTOP OD OS UCVA 0.2 0.6 BCVA 0.9/sf.+5 cyl -6 axis 115 0.9/ -0.5 cyl.-1 axis 120 OS UCVA 0.2 0.7 BCVA 0.8/sf+6 cyl.-6 axis 95 0.9/ -1 axis 65 Escrs 2011

AT LISA toric 909M Toric (anterior surface) Bifocal (posterior surface) SMP technology (smooth micro phase technology) Aberration neutral Easy handling Implantable via injector, 1,5mm incision size Plate haptics For capsular bag implantation Calculated indivudually Cyl.: +1.0 to +12.0 D Diopter: -10.0 to +32.0D Injector system: A2-2000/A6-2000 (single use) Cartridge: ACM2/ACM3 A constant iolmaster (optic): 118,3 Escrs 2011

AT LISA toric 909M Total diameter: 11 mm Optic diameter: 6 mm Design: square edged optic and haptic Optic design: toric, bifocal, equiconvex, aberration-free Material: foldable acrylate with 25% water content, hydrophobic surface, UV-absorber Escrs 2011

Wanted Improvement !!!!!! FEMTOLASIK OO ENDPOINT UCVA OD 1.0 OS 1.0 Escrs 2011

OUR EXPERIENCE FEMTOLASIK AS A TOUCH UP AFTER PREVIOUS REFRACT IVE LENS SURGERY Escrs 2011

REASON FOR TOUCH UP WITH LASIK Patient dissatisfaction Discuss beforehand to pay or not to pay When Improvement possible Exclude all other pathology Escrs 2011

PRE POST LASIK UCVA 47 EYES Escrs 2011

PRE POST LASIK BCVA 47 EYES Escrs 2011

LOSS GAIN OF LINES OF BCVA LOSS OF MORE THAN ONE LINE:not one eye GAIN OF MORE THAN ONE LINE: 4 eyes Escrs 2011

INDICATION Refractive outcome different from plano. Sf.Eq.Myopia in 60% Sf.Eq.hyperopia in 40% Astigmatism > 1 dptr. in 64% of the eyes Escrs 2011

When Astigmatism was present it was Against the rule in 70% When Astigmatism was present it was Against the rule in 70% With the rule in 30% Escrs 2011

TORIC IOL’S No doubt for important astigmatism Minor deviations sometimes better predictability with Femtolasik Escrs 2011

Thanks for the Attention Escrs 2011