The IPure IOL has patients and surgeons alike seeing cataract surgery in a new way.

In this age of instant gratification, ophthalmology patients are difficult to please. Advancements to surgical technology place tremendous pressure on surgeons. And when considering the amount of time that most adults spend on digital screens — research by Scripps says approximately 11 hours per day — the opportunity to evaluate one’s vision is happening endlessly.

Ask Jay Levin, MD, a refractive cataract surgeon, and he’ll tell you that the patients most likely to give feedback following cataract surgery are those who are not yet seeing at the level they anticipated after discussions with their surgeons.

“That tends to be the nature of the business,” says Dr. Levin, a partner and medical director at Horizon Eye Specialists and Lasik Center in Phoenix, Ariz. However, he is seeing a new trend among patients who’ve been implanted with the IPure IOL (BVI). “We’ve been receiving unsolicited comments about how well patients are seeing,” says Dr. Levin. “They’re receiving ranges of vision they weren’t promised or expecting.”

The IOL is also gaining a reputation among surgeons for offering them an easy surgical procedure.

STYLED FOR STREAMLINING

Designed with a focus on efficiency, IPure is the first and only fully pre-loaded aspheric monofocal IOL available in both a one-piece and three-piece design in the United States. While the trend towards pre-loaded injectors is unlikely to change due to the convenience they offer, the novelty of IPure’s performance has a particular impact on preparation and performance. According to Aimee Shimamoto, the U.S. director of marketing at BVI, “there’s no replacing of instruments, no metal injector, no need to re-sterilize — these are single-use and fully disposable. Preoperatively, you have an all-in-one IOL and injector device that only needs to be prepared with an ophthalmic viscosurgical device and inserted,” she says. “The result is enhanced workflow efficiency and productivity.”

Elizabeth Yeu, MD, who specializes in cornea, cataract, and refractive surgery at Virginia Eye Consultants in Norfolk, Va., says the lens’ design has made it her “go-to IOL,” with more than 300 implants through February.

“The pre-loaded feature is fantastic, and the IOL comes out of the injector in pristine condition 99% of the time,” says Dr. Yeu, the first U.S. surgeon to implant IPure. “The only few that I’ve seen with a snagged trailing haptic are when my scrub tech has not loaded enough viscoelastic into the cartridge.”

BETTER VISUALIZATION, IMPROVED VISION

Dr. Levin has implanted the lens in more than 40 patients over the first 6 months of its utilization. He appreciates that the haptics of the lens are blue-tipped, which makes the visualization for the surgeon especially improved. “You see the lens in the injector better, which helps you to implant the lens into the eye more easily,” he says. “You can see where the haptics are and whether or not they’re folded properly so that you’re confident when you’re injecting the lens into the eye.”

Delivery of the lens, from a functional standpoint, is unmatched, according to Ms. Shimamoto. In a 2018 study of 101 human eyes, Chung et al reported “0% required additional manipulation in the eye, whereas as many as 32% of cases using manual-loading delivery required additional manipulation during implantation,” she says.

IPure is also a uniquely designed three-zone aspheric optic with a blended neutral spherical aberration (SA) in the approximately 2.4-mm optic zone while delivering -0.18 microns of SA in the peripheral zone. The result, says to Ms. Shimamoto, is high-contrast image quality in various lighting conditions; a maintained natural corneal depth of focus; and less sensitivity to natural off-axis conditions, lens decentration and corneal aberration. “The neutral SA in the central zone could provide benefits of maintaining natural cornea depth of focus while the negative SA in the peripheral zone of the optic may be especially beneficial in dim lighting,” she says. “Patients get the benefits of high-contrast vision when they need it most.”

Dr. Yeu notes the three-piece also utilizes a 2.4-mm wound size, “which is a huge feature for those cases where a three-piece IOL is preferred. All other three-piece IOLs in the U.S. require manual-loading technique and creating a wound size closer to a 2.75-mm, or larger, opening.”

Each lens is also lathe cut and pad polished to deliver a smooth, even optic surface that reduces light scattering on the lens surface. The lens’ sharp optic edge is designed to reduce posterior capsule opacification.

PATIENT PARTICULARS

While Dr. Levin does not rule out the lens for any patients, he especially recommends IPure for post-refractive patients. Also, he is more frequently selecting IPure for patients undergoing standard surgery who are near-sighted and request excellent distance vision. “I know they’re probably going to miss a little bit of their near-sightedness ability to read without glasses, so I’m choosing this lens to see if I can give them a little bit of that depth of focus,” he explains. “But I don’t tell my patients to expect that.” OM