“Compared to IOLs of the previous generation this is a milestone,” he said.

Overall, he suggests premium lenses for hyperopic patients, “but I’m still a little cautious in myopes.” An addional advantage of the Acri LISA, he said, is that it can be delivered as a toric lens as well.

He prefers microincision cataract surgery and said that this IOL fits through the incision size Source: Jérôme C. Surgeons who choose to offer and implant premium lenses, though, have a much broader range of IOLs than physicians here in the U. Eye World spoke to some leading cataract surgeons to determine how they view the European marketplace, what premium lenses are in studies and which ones are available, and what the general philosophy towards the technology is. S., Europe’s healthcare systems play a major role in the general acceptance of these premium lenses.

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“Most times these outcomes can be fine tuned with further corneal laser surgery but it would be preferable to have improvements in biometry that would make IOL calculations in these post-refractive patients more accurate,” Dr. The first accommodating lenses in Europe didn’t fare as well as in the U. Marques is looking forward to the introduction of the Crystalens HD (Bausch & Lomb Surgical, San Dimas, Calif.).

“Synchrony [Visiogen, Irvine, Calif.] the dual-optic accommodating IOL, is under investigation in Europe (and already with market approval).

Premium or added value lenses in the mainland are an out of pocket expense.” In Italy, if a surgeon is affiliated with a public hospital—and the majority are—“premium lenses are not available unless you’re part of a trial or an instructor is interested in trying them,” said Antonio Fea, M. D., aggregate professor, department of clinical physiopathology, Eye Clinic, University of Torino, Torino, Italy. D., head, department of clinical physiopathology, Eye Clinic, University of Torino, are involved in two premium IOL studies for just that reason, he said. “If a physician is in private practice, they can implant whatever they want.

In the public system, you’re not allowed unless you’re involved in a trial.” Dr. Cummings said, is that “biometry has to be spot-on.

We’re trying to get the European Parliament to try and change this, and allow us to get reimbursement from the patient, but right now that’s not allowed,” Dr. Depending on a hospital’s size, it may be able to negotiate with IOL manufacturers and secure some premium lenses, “but it’s only about 5 to 10%” of the overall number of lenses used, Dr. Toric lenses will be reimbursed by the government, he added, “but only if the astigmatism is high enough.

Not all toric lens patients are covered.” In the United Kingdom, National Health Service patients are “unable to ‘top up’ to get a premium lens,” Dr. “Insurance companies also do not cover these lenses but patients can be balance billed.

Fea said, followed by a finite hospital budget and a lack of long-term performance results on the premium lenses.

“True accommodating lenses are a big dream,” he said. Vryghem said the earlier versions of multifocal IOLs generated enough complaints that “the 10% who complained about them made you forget about all the happy patients.” Dr.

This lens has demonstrated in clinical trials with over 1000 implants in the last five years to provide excellent distance, intermediate and near vision without the usual downsides of the multifocal implants,” he said.