An interview with Philip Smith, MD, a cataract and refractive surgeon with NVISION Eye Centers, Sacramento, CA

QUENTIN B. ALLEN, MD: Which of the findings from the trials of the AcrySof^® IQ PanOptix^® Trifocal Intraocular Lens did you find most compelling as a cataract surgeon?

DR. SMITH: Some patients in the trials were able to see 20/20^*† equivalent at near, intermediate, and distance with very little loss of vision between those focal points.

Overall, 99.2% of all patients that had bilateral PanOptix^® lenses implanted stated they would choose that lens again1 (Figure 1). I think that really underscores the success of this lens.

DR. ALLEN: A high percentage of patients in the trials were satisfied with the PanOptix^® lens, and it is possible to achieve 20/20^*† visual acuity for near, intermediate, and distance (Figure 2). How does that correlate with what you’re seeing in your practice?

DR. SMITH: Many of my patients are able to achieve 20/20^*†1 near, intermediate, and distance vision. The PanOptix^® lens is functioning as advertised, and patients are extremely happy with it. They’re enjoying increased spectacle freedom and the good quality of vision across all spectrums.

DR. ALLEN: Do you typically ask your patients if they’d choose this lens again?

DR. SMITH: When I started using the PanOptix^® lens, I did ask that question, but most of the time now, I don’t even have to ask. Patients volunteer positive comments, such as, “This is wonderful. This is excellent. I’m so happy.”

DR. ALLEN: How has the introduction of the PanOptix^® lens changed how you discuss IOL options with your patients?

DR. SMITH: It’s actually simplified the discussion. When we had only a bifocal option with near and distance vision, I had to take the time to explain to patients that there would likely be a trade-off. They might not have the best near vision, or they might have very good vision at near and not the best vision at distance. A lot of chair time was involved as I explained the functionality of the lenses and prepared patients for outcomes. I never want to oversell a lens and then have a patient disappointed.

With a PanOptix^® Trifocal lens, I don’t have to explain these types of limitations. It delivers near, intermediate, and distance vision without the need for eyeglasses in most cases. The lens pretty much sells itself.

DR. ALLEN: The way this lens performs does make patient education a more positive experience.

DR. SMITH: Yes, definitely. I can now provide a lens that meets the needs of most of my patients. Patients are coming in younger and younger for cataract surgery. Many of them are still working. If I were to use monofocal lenses, they would still need eyeglasses for intermediate and near. Many of them are still quite active, playing tennis and golf, scuba diving, and they would have to have special eyeglasses made or special masks for scuba diving, so that they could continue with these activities.

These younger patients are also the people most likely to want spectacle freedom. They have that option now with the PanOptix^® Trifocal lens, and it covers all ranges.

DR. ALLEN: What has been the deciding factor for patients to choose this lens?

DR. SMITH: Freedom from spectacles is a top priority. Patients’ expectations are quite high. They believe they will never have to wear eyeglasses again after cataract surgery.

In the past, I’ve had to say, “Sorry, no. That’s not how it works. We’ll remove your cataract, but you’ll still need eyeglasses for some activities.”

Today, when patients are motivated to eliminate eyeglasses, we have that opportunity with the PanOptix^® lens.

DR. ALLEN: Postoperatively, what can patients expect with regard to their vision?

DR. SMITH: In my experience, the PanOptix^® lens requires very little adaptation, and patients adapt to it quickly. There’s always some degree of swelling and inflammation after cataract surgery, so patients may not experience their best vision on day 1 postoperatively, but typically by the second or third day, they’ve already gained a couple of lines of vision, and close to 20/20 visual acuity 2 days out. Vision recovery is extremely quick.

DR. ALLEN: Is this lens exceeding patient’s expectations? And if so, why do you think that is?

DR. SMITH: Patients are coming in with high expectations. Now, with the PanOptix^® lens, I believe we are able to meet those expectations for many of our patients.

DR. ALLEN: Are your patients reporting any notable life changes after receiving the PanOptix^® lens?

DR. SMITH: Patients often mention how an everyday task, such as driving, is so much easier. They can read street signs quicker; they can see their dashboards, and they can drive at the same time with less dependence on glasses. Patients also love that they can wear nonprescription sunglasses. It opens up a world to them that they’ve never experienced before with fashion, too.

DR. ALLEN: How do you address unwanted visual disturbances postoperatively?

DR. SMITH: I address them preoperatively, by discussing the possibility of halos and glare prior to surgery. If they do occur, I can remind patients that we discussed this and that most patients in the trials were not bothered by them. I’ve found that if patients understand that these disturbances can occur, they are more likely to accept them if they do experience them.

DR. ALLEN: Dr. Smith, are you now more confident when offering the PanOptix^® Trifocal lens to your patients?

DR. SMITH: Definitely. I’m very impressed with the outcomes and with patients’ reports of satisfaction with the lens. I even tell my patients that my mother is going to have cataract surgery, and she plans to get the PanOptix^® lens.

DR. ALLEN: What would you say to the surgeons who still aren’t using the PanOptix^® lens?

DR. SMITH: I would tell them to look at the data. Look at the outcomes. Trust the science when it comes to the development of the technology, and then talk to your colleagues. The PanOptix^® lens performs so exceptionally well that if they’re not using it, they’re missing out on countless opportunities to help many patients. •

REFERENCE

1. AcrySof^® IQ PanOptix^® Directions for Use.

^*Based on mean value of binocular defocus curve at near, intermediate and distance at 6 months (n=127)

^†Snellen VA was converted from logMAR VA. A Snellen notation of 20/20-2 or better indicates a logMAR VA of 0.04 or better, which means 3 or more of the ETDRS chart letters in the line were identified correctly.