Tecnis Symfony OptiBlue IOL with InteliLight looks to deliver on the promise of next-generation IOLs.

Johnson & Johnson Vision’s Tecnis Symfony OptiBlue IOL with InteliLight is the company’s latest IOL added to its extended depth of focus (EDOF) platform.

The Tecnis Symfony was the first EDOF IOL to win FDA approval for the treatment of presbyopia. Then, in 2021, J&J launched its hybrid EDOF/trifocal lenses, the Tecnis Synergy and the toric Tecnis Synergy Toric II.

The new Symfony OptiBlue IOL with InteliLight technology features three proprietary innovations: violet light filtration, a new echelette design and achromatic technology (first introduced in the Tecnis Synergy). This next-generation IOL is also available on the Toric II platform to treat cataract patients with astigmatism.

According to J&J, this new line of presbyopia-correcting IOLs “supports the gap in contrast and low-light performance by delivering excellent uncorrected visual acuity at all distances¹ while mitigating dysphotopsia² and providing high image contrast day and night.”^1,3,4

PATIENT PROFILE

The IOL has been created to address the unique needs of older adults, according to the company. Contrast sensitivity and low-light visual performance are critical to patients’ ability to maintain independence and an active lifestyle as they age.⁵ Decreased contrast sensitivity can reduce mobility and cause fear of falling, becoming a key factor in patients’ ability and confidence driving — especially at night.^6,7 In fact, contrast sensitivity may be more important than visual acuity for some activities.^1,2

THREE KEY FEATURES

Specifically, here are three key features of the Symfony OptiBlue:

1. Violet-light filter. This blocks the shortest wavelengths of light that produce the most light scatter,^8-10 helping to mitigate halo, glare and starbursts^11-14 and minimize visual disturbances when driving at night.¹²
2. Echelette design with a high-resolution lathing. This helps reduce light scattering and halo intensity,^11,14 making it easier to see digital devices.^12,13
3. Achromatic technology. It corrects chromatic aberration for better contrast day and night^8,13 and superior performance across every distance.^15,16

“Patients’ active lifestyles require confidence in all of their activities at all times of day,” says Nikki Sidi, vice president, global strategic marketing, Surgical Vision, Johnson & Johnson Vision. “The InteliLight PCIOL portfolio delivers best-in-category contrast and low-light performance.”^15-17

SURGEON PERSPECTIVES

Karolinne Rocha, MD, PhD, and colleagues at the Medical University of South Carolina, Mount Pleasant, S.C., performed prelaunch surgeries using the Tecnis Symfony OptiBlue. She noted that because the lens is on the Symfony platform, it leverages the technology’s high Abbe number, low refractive index, negative aspheric aberration and achromatic technology to account for chromatic aberration.

“We have found that the OptiBlue does mitigate night vision symptoms. Although it does not completely eliminate dysphotopsias at night — patients may still see spider webbing or halos around lights, especially LED lights — importantly, patients are not complaining about these symptoms,” Dr. Rocha says. Her clinic is conducting a postoperative study to inquire about night vision symptoms in patients receiving the lens as well.

“With its lens’ combination of violet blocker, plus the chromatic and spheric aberration correction, patients are achieving very high quality vision,” she says.

While Dr. Rocha believes OptiBlue is a great choice for active patients who desire spectacle independence for most activities, having an EDOF lens in both eyes will leave patients needing over-the-counter readers for very small print, she notes. So, in qualified patients, Dr. Rocha now prefers to implant the OptiBlue in the dominant eye and the Synergy lens in the nondominant eye. “This combination gives patients the best reading vision, J1 plus.”

However, she notes that those patients who have untreated dry eye or extrafoveal epiretinal membrane, for example, would not be the best candidates. “For them, I would do bilateral Symfony OptiBlue targeting low minus for the nondominant eye to maximize intermediate/near vision and plano for the dominant eye.”

Daniel Chang, MD, presented retrospective clinical data at the 2022 ASCRS meeting from a prospective, single-center consecutive case series comparing outcomes following implantation of either the Tecnis Symfony IOL (63 eyes of 43 patients) or the Tecnis Symfony OptiBlue IOL with InteliLight (73 eyes of 48 patients).¹⁸ Visual and refractive outcomes were similar among both groups at months 1 and 3. The Symfony OptiBlue group showed a 45% reduction in dysphotopsia complaints at months 1 and 3. The percentage of patients who had any documented postoperative counseling for dysphotopsia was significantly lower at months 1 and 3 in the Symfony OptiBlue group compared with the traditional Symfony IOL group, with a 72% reduction in dysphotopsia-related counseling occurring at 3 months.¹⁸

High-quality contrast and dysphotopsias are not the same thing, Dr. Rocha says. High-quality vision or contrast is the ability to see well under lower light conditions, and it is dependent on light transmission to the retina. “Dysphotopias … are related to the diffractive index or the rings,” she says. “The violet filter in the Symfony OptiBlue IOL with InteliLight blocks that extra short wavelength, benefiting patients with an increase in contrast and improvement in the night vision dysphotopsia.” OM

Disclosures: Dr. Rocha and Dr. Chang are consultants to J&J Vision.

REFERENCES

1. Data on file. DOF2020OTH4010. Johnson & Johnson Vision, Inc. Santa Ana, Calif.
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4. Data on file. DOF2020OTH4011. Johnson & Johnson Vision, Inc. Santa Ana, Calif.
5. Fisus AD, Madaras Z, Horbath KU. The prevalence of dysphotopsia in patients with recent cataract surgery. Acta Medica Marisiensis 2017;63:15-18.
6. Rosenthal B, Fischer M. (2014) Functional vision changes in the normal and aging eye. In TL Kauffman (Ed.) Geriatric Rehabilitation Manual (2nd Ed, Chpt 51, pg 381-391). China: Elsevier Ltd.
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8. ARVO 2020_Effect of blocking violet light in extended depth of focus IOL: SC2019CT4056.
9. Mainster MA. Blue-blocking intraocular lenses: Myth or reality? Am J Ophthalmol. 2009;1:8-10. REF2014CT0140 Blocks shortest wavelengths (p.1).
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11. Effect of blocking violet light in EDOF IOLs. JNJ ArvoAbstractMay 2020/Optical and visual performance of violet blocking IOL SC2019CT4025.
12. DOF2020CT4011: DOF Effect of blocking violet light on light scatter in Tecnis Symfony IOLs (v1.0).
13. InteliLight US Sales Aid. PP2022MLT5751
14. DOF2021CT4019 - Clinical investigation of rotational stability of the TECNIS™ Toric II IOL- Steele Study NXGT-202-QROS. 20 Aug. 2021.
15. World Health Organization. Blindness and Impairment. InteliLight technology features three proprietary innovations. Accessed January 1, 2023.
16. American Optometric Association. Cataract. https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/cataract?sso=y . Accessed January 1, 2023.
17. World Health Organization - Priority Eye Diseases. REF 2016 OTH 0004.
18. Chang DH, Kao AA, Huggins LK. The effect of violet light filtration and manufacturing improvements on the clinical performance of an extended depth of focus IOL. Paper presented at: American Society of Cataract and Refractive Surgeons annual meeting; April 25, 2022; Washington, D.C.