Long-Term Quantitative Analysis of Posterior Capsule Opacification After Implantation of Dual-Optic Accommodating IOLs Andrea Galvis, MD 1 , 3 Ivan Ossma Gomez,MD MPH 1 , 2 1 Fundación Valle del Lili Cali, Colombia 2 Universidad Industrial de Santander Bucaramanga, Colombia 3 Fundación Oftalmológica de Santander Bucaramanga, Colombia Authors are clinical investigators for the Synchrony Dual Optic Accommodating IOL

Synchrony Dual Optic Accommodating IOL Fills the capsular bag Designed to provide accommodation via forward movement of the anterior optic Potential for movement could be impaired by capsule opacification ACO PCO Galvis et al

Clinical Experience Synchrony Good unaided distance, intermediate and near visual function 1,2,3 Subjective and objective evidence of accommodative amplitude 4,5,6 Stability of over 2 years 1,2 Low PCO rates 7 Functional range of vision exceeding that of multifocals 8 Over the past 5 years, several authors including myself have shown that the Synchrony Accommodating IOL yileds good unaided visual function at all ranges, with objective evidence of accommodation and stability throughout time. Additionally the lens has very low rates of capsule opacification. 1 Alarcon et al. ESCRS London 2006 2 Ossma et al. ASCRS San Francisco 2006 3 Beiko G. ESCRS London 2006 4 Ossma et al. ASCRS San Diego 2004 5 Galvis et al. ASCRS Washington 2005 6 Bohorquez et al. ESCRS London 2006 7 Galvis et al. ESCRS Berlin 2008 8 Ossma et al. ASCRS Chicago 2008 Galvis et al

Rabbit Studies* *Werner et al. JCRS 2004; 1114-23 Synchrony Plate Haptic IOL Difference in PCO Synchrony 0.714 ± 0.751 Plate haptic IOL 3.142 ± 0.899 *Werner et al. JCRS 2004; 1114-23 Galvis et al

Study Design Prospective Observational Analytical Study 3 Groups Synchrony IOL Implantation (43 eyes) Alcon SN60D3 (42 eyes) Alcon SN60AT Implantation (54 eyes) Galvis et al

Study Design Digital retroillumination photographs (3,6,12 and 24 months) Evaluate incidence PCO OSCA System Evaluate incidence ACO Photography grading one observer Galvis et al

OSCA (Open Access Systematic Capsule Assessment) Aslam et al. ¹-²-³ Based on texture analysis Objective Valid Reliable ¹ Aslam et al. BMC Ophthalmology 2005, 5:9 ² Aslam et al. BMC Ophthalmology 2006, 6:30 ³ Paton et al. BJO 2002, 86:1181-87 Galvis et al

* Kruskal Wallis Analysis of Variance Study Population Synchrony (n=43) SN60D3 (n=42) SN60AT (n=54) * Age 68.8 ± 5.4 68.5 ± 5.4 70.1 ± 5.6 p=0.55 Residual Refraction Defocus Equivalent 0.32 ± 0.153 0.22 ± 0.184 0.20 ± 0.157 p=0.48 * Kruskal Wallis Analysis of Variance Galvis et al

Results Alcon SN6AD3 21.3 months postop Synchrony 20.7 months postop Alcon SN60AT 21.1 months postop Galvis et al

CLINICALLY SIGNIFICANT PCO OSCA Score Evolution CLINICALLY SIGNIFICANT PCO p=0.41 p=0.83 OSCA Score p=0.27 p=0.38 Mann-Whitney Test Galvis et al

Anterior Capsule Opacification Month 12 Synchrony n=43 SN60D3 n=42 SN60AT n=54 None - Mild 40 (93.1%) 35 (83.3%) 47 (87%) Moderate 3 (6.9%) 7 (16.7%) 6 (11.1%) Severe 1 (1.9%) Fisher’s Exact Test p=0.37 Galvis et al

Conclusion Elements in design of Synchrony Dual Optic Accommodating Intraocular Lens Minimize ACO Minimize PCO Synchrony Dual Optic Accommodating IOL PCO Rates comparable to those of acrylic monofocal and multifocal IOLs Galvis et al

Thank you andreagalvis@mac.com www.perfectavision.com