Providing consistency and efficiency are among its attributes.

Neel Desai, MD, cornea, cataract and refractive surgeon and director of ocular surface disease at The Eye Institute of West Florida in Largo, says he was an early adopter of Bausch + Lomb’s SimplifEYE IOL delivery system because it provides consistency and efficiency. SimplifEYE is available exclusively for Bausch + Lomb’s enVista MX60PL and enVista toric MX60PT, making it the first preloaded toric IOL in the United States.

Having the lens preloaded reduces the risks associated with handling, Dr. Desai says. For example, a surgical scrub nurse’s experience — which can affect how quickly they load the lens and how well they do it — doesn’t matter.

“I get consistent, smooth control of IOL delivery every time,” Dr. Desai says.

Because it’s preloaded, less manipulation of the IOL is needed by hand or instrument, which limits the risk of a dropped lens, scratched lens or amputated haptic, he explains. If a lens isn’t loaded correctly, an IOL can shoot out of the cartridge or rotate unexpectedly when delivered.

SimplifEYE also saves time. The lens is ready to be placed in the eye within 10 seconds of the technician touching the device, Dr. Desai says.

SURGEON PRAISE

“The enVista lens is my go-to monofocal IOL; the SimplifEYE lens delivery system is a favorite approach for our surgery center due to its efficiency and control of consistency across the board,” Dr. Desai says.

Dee Stephenson, MD, FACS, founder and CEO of Stephenson Eye Associates in Venice, Fla., was the first surgeon globally to use SimplifEYE with the toric lens. She can use the system for all patients, even those with zonulopathy. The platform is ideal for post-refractive patients. The aberration-free enVista lens allows the cornea to retain its natural spherical aberration so it has very low incidences of dysphotopsias. Dr Stephenson says it centers well, is rotationally stable and can be used to treat a broad range of astigmatism, from 0.77 up to 4.53.

Because both lenses are uniform power center-to-edge, neither are affected by tilt and decentration. “If a lens moves slightly, it won’t affect vision quality … it’s a forgiving lens,” Dr. Stephenson says.

HOW IT WORKS

The SimplifEYE delivery system facilitates implantation of enVista lenses into the capsular bag through an incision as small as 2.2 mm in three steps: attach the preloaded shuttle to the injector body, apply the viscoelastic and advance the plunger, says Chuck Hess, vice president and general manager at Bausch + Lomb U.S. Surgical. The enclosed SnapSet cartridge houses an untouched IOL to help ensure proper positioning and reduce the risk of lens damage.

Patients heal quickly due to the small incision. The shorter surgical time means reduced chances of inflammation and infection, Dr. Stephenson notes. “The outcomes are very predictable.”

SimplifEYE’s beveled tip permits consistent lens folding to give surgeons reproducible and reliable delivery of the enVista IOL into the capsular bag. Clear construction provides excellent visualization of the IOL during implantation, and the proprietary coating technology of the inserter eliminates linear additive transfer deposits on the surface of the IOLs after implantation, Nanavaty and Kubrak-Kisza reported in 2017. Finally, a convenient viscoelastic port ensures proper IOL lubrication that allows for smooth passage of the IOL during delivery.

CLINICAL APPLICATIONS

The enVista MX60PL offers a wide range of powers (0 D to 34 D). The enVista toric MX60PT offers rotational stability and the lowest cylinder power of 1.25 D, which allows surgeons to correct more astigmatic patients, Mr. Hess says.

Both preloaded lenses also offer the benefits of a zero spherical aberration optic with excellent defocus tolerance and contrast sensitivity as well as StableFlex technology, which provides improved material properties to deliver quicker unfolding and enhanced optic recovery following delivery, Mr. Hess says.

“The new delivery system allows for streamlined IOL insertion,” Dr. Stephenson adds. “The lens unfolds quickly, which enhances efficiency in the operating room.”

About 85% of Dr. Stephenson’s patients have 20/40 intermediate vision after surgery using SimplifEYE. They don’t need glasses for distance or intermediate vision; only some require reading glasses. The IOL gives great intermediate range of vision and depth of focus, she says, which she attributes to SimplifEYE’s effective lens positioning.

ELIMINATE INCONSISTENCIES

While SimplifEYE’s advantages benefit any ophthalmology practice, Dr. Desai notes that it is particularly useful in large multi-specialty ASCs or hospital-based ASCs where there are concerns for intra-user consistency and reliability.

“Some surgery centers might have nurses switching from cardiac to gastrointestinal surgery to an eye case; they may not be that experienced in ophthalmology,” he says. “As a result, this may force a surgeon to load the lens themselves, which decreases efficiency.”

EASE OF USE

High-volume surgeons and those who have operated for many years may experience cramping and carpel tunnel issues when doing repetitive motions over time, even if a device has minimal resistance, Dr. Desai says. Because the platform provides for smooth IOL delivery with minimal effort and resistance, it reduces surgeon fatigue with repetitive motions.

“It’s one of the easiest IOL delivery platforms I’ve used,” Dr. Desai says. “It will add months if not years to my career because I’m avoiding ergonomic issues over time.” OM