Factors which Influence Accommodative Amplitude in Crystalens HD Patients Uday Devgan, MD, FACS Devgan Eye Surgery, Los Angeles, CA FINANCIAL DISCLOSURES: Abbott Medical Optics: consultant, research, stockholder; Accutome Inc: speaker; Alcon Laboratories: stockholder ; Allergan: consultant, speaker, research funding, stockholder; Bausch & Lomb: consultant, research funding; Calhoun Vision: research funding; Gerson Lehman Group: consultant; Inspire Pharma: stockholder; Ista Pharma: consultant, speaker, stockholder; iTherapeutix: research funding, travel support; Optos Inc: speaker, consultant; Pfizer Inc: speaker, stockholder; Sirion Therapeutics: consultant; Specialty Surgical: stockholder; Staar Surgical: consultant (former), speaker, stockholder; Zeiss: speaker

Who are the best Crystalens HD patients and why?

Study Design Retrospective analysis of 80 patients Retrospective analysis of 80 patients Single surgeon (UD) Single surgeon (UD) Examination of the distance vision eye only Examination of the distance vision eye only To avoid benefit of mono-vision / mini-mono To avoid benefit of mono-vision / mini-mono Near vision measured through best-corrected distance vision Near vision measured through best-corrected distance vision

Evaluation Patient Age:<6565+ Patient Age:<6565+ Prior LASIK:yesno Prior LASIK:yesno Axial length: 26 mm Axial length: 26 mm Capsulorrhexis: 5.5mm Capsulorrhexis: 5.5mm IOL Orientation:verticalhorizontal IOL Orientation:verticalhorizontal

AGE: Younger or Older Not statistically significant (P > 0.10) N=36BDCNVA=J3.5 Age < 65 years Age > 65 years N=44BDCNVA=J4.1

Prior LASIK, PRK, RK Not statistically significant (P < 0.10) N=28BDCNVA=J2.9 Prior Refractive Sx Virgin eye N=52BDCNVA=J3.7

Axial Length Not statistically significant (P < 0.10) N=68BDCNVA=J3.7 Normal (<26mm) High Myope (>26mm) Or previous myope s/p LASIK N=12BDCNVA=J2.8

Capsulorrhexis Size No data N=1Ant Cap YAG done < 5.5 mm > 5.5 mm N=79

IOL Orientation Not statistically significant (P > 0.10) N=47BDCNVA=J3.6 Vertical Horizontal N=33BDCNVA=J3.7

Problems with my Study Patients fell into multiple categories: Patients fell into multiple categories: Prior LASIK more common in younger patients Prior LASIK more common in younger patients Long Axial Length more common in younger patients and prior LASIK patients Long Axial Length more common in younger patients and prior LASIK patients Not enough patients Not enough patients Post-op timing of results should have been consistent Post-op timing of results should have been consistent Need longer follow-up in post-op period Need longer follow-up in post-op period Near vision not always measured at 16 inches Near vision not always measured at 16 inches

Conclusions: No statistically significant answers No statistically significant answers Suggestions (Not Proven): Suggestions (Not Proven): Prior LASIK patients may do better perhaps due to other ocular aberrations Prior LASIK patients may do better perhaps due to other ocular aberrations Patients with an Axial length > 26 mm may do better due perhaps due to thin IOL, optics. Patients with an Axial length > 26 mm may do better due perhaps due to thin IOL, optics. Needs further analysis Needs further analysis