EyeWorld Asia-Pacific June 2024 Issue

REFRACTIVE SURGERY

Results so far have been positive. Dr. Waring said he presented 6-month outcomes at the 2023 ASCRS Annual Meeting, showcasing that 95% of eyes were within a half diopter of plano at 6 months. Ocumetics accommodating lens by Ocumetics Technology Corp. The Ocumetics accommodating lens is a shape-changing lens that was developed by Dr. Garth Webb, beginning in 2007, said R. Doyle Stulting, MD, PhD. The lens is implanted into the capsular bag. “When the ciliary body contracts, tension on the lens zonules is reduced, and the refractive elements of the Ocumetics lens increase its refractive power through a patented process involving a small, air-filled space,” Dr. Stulting said. It is constructed of solid silicone and does not contain liquid silicone or any potentially toxic substance, he said, and the change in refractive power is almost instantaneous. Dr. Stulting said that the simple design of the lens mimics the natural crystalline lens. “It is contained completely within the capsular bag, does not impinge on the ciliary processes, does not contain any liquids that might escape, does not involve any electronics, and rapidly changes its power in response to ciliary body contraction/relaxation,” he said. Any patient undergoing cataract surgery would be a candidate for implantation of the Ocumetics lens, Dr. Stulting said. “Current implants either do not permit clear near vision (monofocal IOLs), optically split incoming rays of light between near- and distance-focusing elements of the lens (multifocal lenses), or optically expand the range of focus,” he said. “None of these products provides sharp near and distance vision without compromise.” All ophthalmologists are aware of visual aberrations attributable to these lenses, some of which lead to lens explantation. At some point in the future, the Ocumetics lens may even be used to treat presbyopia in individuals who have not yet developed cataracts, he added. Dr. Stulting said the lens requires minimal to no adjustment from patients, since the Ocumetics lens closely mimics the action of the natural crystalline lens. The lens has undergone pre-clinical testing, but first-in human trials have not yet begun. These are planned for Q2 2024, Dr. Stulting said.

The OmniVu modular shape changing IOL is a fixed-power front optic and fluid-filled, shape-changing base lens. Source: George Waring IV, MD, and Atia Vision

filled base.” The front fixed-power optic docks into that, and it’s a modular system that allows for customization in the future, he said. This lens is designed to restore a full range of vision and minimize visual disturbances that can be seen with other presbyopia-correcting solutions, Dr. Waring said. When the body attempts to read, you have the ciliary muscles exert a force on the capsular bag, and that translates to a shape-changing base that results in the base optic thickening in curvature, and that’s what increases the power for reading, he added. The OmniVu lens has been evaluated in pilot studies, and Dr. Waring noted that there is 1-year data available for two sites. It’s currently designed for patients with under 1.5 D of astigmatism and is being looked at for opportunities for a toric platform in the future, he said. The power range is currently 12–28 D, coming in half diopter increments. Efforts are underway to assemble the U.S. IDE trial. Dr. Waring noted that there are some nuances to the surgical procedure, but overall, these involve the same fundamental principles of phacoemulsification and cataract surgery. Since it’s a two-piece modular lens system, it’s done in two steps utilizing a 3.5-mm incision and then an intended 5.5-mm manual capsulotomy. You do want to be careful with incision size and also capsulotomy diameter, he said. Because of the nature of the optics, this has an excellent visual quality, contrast sensitivity, and dysphotopsia profile, Dr. Waring said. “In addition, it seems there are some lesser understood benefits of capsular filling technology in terms of effective lens position and reduction of posterior capsular opacification, and that’s very exciting for the future,” he said.

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EyeWorld Asia Pacific | June 2024