1. 1 Comparison of Distance Image Quality with Accommodating and Multifocal Aspheric Presbyopia-Correcting IOLs John F. Doane, M.D., F.A.C.S. Discover Vision Centers Kansas City, Missouri, USA

2. 2 Financial Interest Investigator for: ReVision Optics, Bausch & Lomb, Carl Zeiss Meditec, Calhoun Vision, LenSx / Alcon This presentation represents the speakers professional experience.

3. 3 Image Quality Extremely important Individual tolerances Individual appreciation

4. 4 So, what is the PROBLEM?

5. 5 Multifocality

6. 6 100% of Light Rays at All Distances

7. 7 Crystalens ® AO Introduction 5 th generation Crystalens –Lineage: AT-45, AT-45SE, Five-O, HD Aberration free optic design Aspheric: anterior & posterior surfaces No Spherical aberration Less sensitive to decentration Designed for improved quality of vision FDA Approved 10-23-2009

8. 8 Diffractive IOL WARNINGS: 1. Some visual effects may be expected due to the superposition of focused and unfocused multiple images. These may include some perceptions of halos or radial lines around point sources of light under night-time conditions. 2. A reduction in contrast sensitivity as compared to a monofocal IOL may be experienced by some patients and may be more prevalent in low lighting conditions. Therefore, multifocal patients should exercise caution when driving at night or in poor visibility conditions. Package insert warnings underscore the visual impairments associated with a multifocal IOL 7 ReSTOR package insert Package Insert Warnings

9. 9 Presbyopic IOL Comparative Function My Data * Data on file Insufficient number of binocular data at 3 months for Tecnis MF

10. 10 Binocular UCDVA 3 Months Post-op AO and ReSTOR

11. 11 Binocular UCIVA 3 Months Post-op

12. 12 Binocular UCNVA 3 Months Post-op

13. 13 Results Monofocal IOLs have superior optical performance ~ contrast sensitivity, MTF Multifocality with splitting of light results in a trade off of greater range of vision but negative consequences to vision quality

14. 14 Thank You For Your Attention /®denote trademarks of Bausch & Lomb Incorporated and/or its affiliates. All other brand/product names are trademarks of their respective owners.

15. 15 If you had a presbyopic IOL implanted in your own eye what would you be more willing to live with if you had to? Question #1 a. Readers for near b. Night symptoms c. Slightly blurred image at all focal points