1. Progressive Multifocal Intraocular Lens G. Rubiolini M.D. Italy www.grvision.com Disclosure of finanacial interest Author's research is partially funded by Imperial Medical Technologies (Cartersville GA, USA) producing, developing and supplying the product presented

2. PURPOSE This is the first clinical trial to evalutate safety long term visual outcomes in a selected group of patient with cataract of this "premium" IOL, available in two versions: modified “C” style Micro-Incision Plate style “Progressive Multifocal” lens that uses a new optical geometry.

3. Materials and methods  35 patients (20 F,15M. Mid age 56) had bilateral Progressive Multi-Focal Intraocular Lenses implants with a non-linear reading add from +3.0 Diopter to +4.5(progressive)during cataract surgery ( PRESBIOPTICx by IMT, Cartersville GA USA). Exclusion criteria included but was not limited to astigmatism >1D, diabetic retinopathy, maculopathy and previous ocular surgery.

4. Materials and methods  Biometry: IOLMaster Zeiss  Target refraction: emmetropia  Facochop procedure (Stellaris B&L)  IOL implantation in the capsular bag.  Injector : Medicel VISCOJECT TM 2.2 mm

5. Materials and Methods E IOLs characteristics  Optic 6 mm  Length 11 mm (plate) 12 mm (c- loop)  AC Depth 5.3 mm  A constant 118.4  Sugested IOL formula : Holladay  Biometry: IOLMaster Zeiss  Target refraction: emmetropia PRESBIOPTICx Micro Incision PRESBIOPTICx Modified “C”

6. Implanting PRESBIOPTICx TM 18.0D + 4.00 4.10D - 4.30D 19.0D + 3.80 3.90D – 4.10D 20.0D + 3.60 3.70D – 3.90D 21.0D + 3.40 3.50D – 3.70D 22.0D + 3.20 3.30D – 3.50D 23.0D + 3.00 3.10D – 3.30D First Lens Implanted - If emmetropia & near vision achieved then the second lens Implanted is identical. First Lens Implanted - If near vision is not achieved then second lens can correct the problem. DIOPTER OPTICAL ADD 2 nd Lens Availability

7. IOLs surfaces comparisons PRESBIOPTICx HP60CM Imperial Medical Technologies Cartersville, GA USA Standard Multifocal IOL

9. RESULTS: 12 to 24 months follow up  Total freedom from glasses was achieved in 28 patients (>80%) with two similar near addition implants (Standard PRESBIOPTICx).  5 patients received an extra 0.40D addition for the second eye (Customized PRESBIOPTICx). Considering this group too, 33 patients (95%) achieved J2 best uncorrected near visual acuity with bilateral vision.  100%of the patients achieved 20/25 or better uncorrected visual acuity for distance.  2 Patients complained some temporary (2-3 months) night vision problems such as glare, halos and sparkles (5,7%).

10. CONCLUSION  This revolutionary progressive addition system for multifocal IOLs provides a excellent visual acuity for distance and near and it can be eventually customized.  Full range vision can be achieved in 95% of the cases.  We found a significant reduction of temporary side effects of multifocal IOLs such as glare, halos and sparkles (5,7%).

11. Thank You