My name is Zarmeena Vendal; I'm a cataract surgeon and glaucoma specialist in Austin, Texas, and I've been practicing there for the last 20 years. I'd love to tell you about my study that I presented today at ASCRS in regards to cataract surgery in our glaucoma patients. More and more, all of us are encountering glaucoma patients who are active. They have often very mild disease and they are really looking for as much glasses independence as possible, just like all of the rest of our cataract surgery patients. So this really prompted us to look at what are these patients candidates for when it comes to IOL selection. Unlike other cataract surgery patients, issues of contrast sensitivity and nighttime aberration really become a big deal in our glaucoma patients. So our purpose with this study became to study specific lenses that might be beneficial for this subgroup.

We looked in particular at the violet light-filtering Johnson & Johnson Tecnis Symfony OptiBlue IOL implant for glaucoma suspects and patients with primary open-angle glaucoma. Why this lens in particular? The violet filter on this lens blocks the shortest wavelengths of light, and those wavelengths are really responsible for the majority of light scatter. So the thought here is better contrast, better handling of nighttime vision issues. That was the impetus for studying this lens in particular, this was an ambispective study where we implanted the lens bilaterally, single surgeon implantation. The distance eye targeted for plano and the near eye for minus a half - very slight mini monovision.

I'm very excited to share our results. When we looked at vision, 80% of our patients experienced 20/20 vision for distance. But what was amazing is 100% of our patients when tested binocularly, had 20/30 or better at distance, intermediate, and near. And if you distill the data down, about 60% of patients had that vision at near. This is very promising for mitigating intermediate and near vision glasses needs in our patients.

Another thing we looked at is really patient satisfaction and how the patients were perceiving their experience. So we looked at a vision questionnaire and we looked at a satisfaction questionnaire. Almost 80% of our patients said that they required little or no glasses at all times with this particular lens platform. And at any given time, we said, well, how many times in the last week did you need glasses? Eighty percent of the patients said that they virtually did not. Ninety-five percent of patients said that they were spectacle independent for distance, 87% said they were spectacle independent for intermediate. Think about that: these are the "near spaces" for our patients these days. We're talking about the dashboard, computer, laptop, and 87% of the time, patients felt that they did not need glasses for doing those activities.

One last very important question is regarding halos and starbursts. This is a very meaningful data point in long-term management of vision in these glaucoma patients. About a quarter of our patients, as expected, felt that they did have dysphotopsias at night. The lens is a diffractive IOL. It is an EDOF lens, but it does split light. The nighttime dysphotopsias were expected, but what we loved about satisfaction questionnaires was that 80% of those patients who said that they did have dysphotopsias said they were not bothered by them. So in conclusion, we really felt comfortable with the fact that the Tecnis Symfony OptiBlue IOL platform is something we now can comfortably offer our patients with mild glaucoma or those who are glaucoma suspects. Now we have something in our toolbox and can say to our patients, there is an option for you as well, as opposed to writing off their desire for spectacle independence and mitigation of their intermediate and near needs when it comes to glasses. So hopefully this is helpful to those of us that deal with glaucoma patients, and we're super excited about our data.

Source: Ophthalmology Management