16-May-19

EDoF IOL AT LARA vs TRIFOCAL IOL AT LISA TRI

Dr. Nabil Ragaei Kamel

Head of The Department of Ophthalmology
Quironsalud San jose Hospital –Madrid
Quironsalud Marbella Hospital- Marbella
Universidad Europea de Madrid
SPAIN

EDoF IOL AT LARA vs TRIFOCAL IOL AT LISA TRI

Fewest dysphotopsia, Fewest dysphotopsia, Spectacle independence Spectacle independence for Spectacle independence
Glasses needed for reading Glasses needed for reading for reading and distance distance & inter-mediate. for all activities
and intermediate and intermediate Less dys-photopsia than
trifocals

VA VA VA VA VA

D I N D I N D I N D I N D I N

Conservative patients Conservative but quality Patients with a special Patients with an active Premium patients with a
accepting to wear glasses conscious patients accepting focus on spectacle lifestyle accepting reading high urge for spectacle
to wear glasses independent near vision glasses independence

CT LUCIA 201 CT SPHERIS CT LUCIA 601 CT ASPHINA AT LISA AT LARA AT LISA tri

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EDoF IOL AT LARA vs TRIFOCAL IOL AT LISA TRI

LISA concept

L Light distributed asymmetrically between distant

and near focus for improved intermediate vision
and greatly reduced halos and glare

I Independency from pupil size due to high performance

diffractive-refractive microstructure covering the complete
6.0 mm optical diameter

S SMP technology for a lens surface without any right angles

for ideal optical imaging quality with reduced light scattering

A Aberration correcting optimized aspheric optic for

better contrast sensitivity, depth of field and sharper vision

AT LARA 829

The perfect balance…

…between increased …and less dysphotopsias
spectacle independence & visual side effects

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ZEISS AT LARA

NEXT GENERATION
Extended Depth of Focus (EDoF) IOL

▪ Widest range of focus within EDoF segment

▪ Less visual side effects than multifocal IOLs

Cataract and refractive surgeons can now have

more choice for different patient needs:
▪ AT LARA offers a perfect balance for
patients seeking spectacle independence
for an active lifestyle with less side effects
▪ AT LISA tri is a gold standard for patients
seeking maximum spectacle independence

AT LARA 829MP

Hydrophilic acrylic (25%) with hydrophobic

surface properties
4 point-haptic design
MICS (1.8 mm)
Pre-loaded BLUEMIXS injection system
360° anti-PCO ring and sharp edges

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The next generation EDoF IOL:

AT LARA 829

▪ LIGHT BRIDGE Optical design

Diffractive optical design with far dominant

light distribution and 2 power additions
creating an optical bridge effect to extend
the range of focus

▪ Smooth Micro Phase (SMP) Technology

Patented design and manufacturing

technology, minimizing light scattering and
glare by including the manufacturing
process into optical design optimization

AT LARA 829MP – Aspheric optics

• Contrast Sensitivity Optimization

▪ Corrección cromática avanzada
▪ The diffractive design is balanced such that material-based chromatic aberrations are to a large
degree neutralizing by the chromatic aberration from the diffractive grating
▪ Aspheric designs in IOLs:

▪Use residual corneal asphericity for focus ▪Reduce residual asphericity

extension
▪Maximize image quality and contrast
▪Better performance if tilted
▪Neutral to corneal ‘abnormalities‘(post-LASIK)

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ZEISS AT LARA
Superior optical performance inducing
less visual side effects than multifocal IOLs

AT LARA 829 Technical data

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AT LARA 829

Defocus curve (n=25)

AT LARA shows better VA in a wider focus

range compared to AMO Symfony

AT LARA 829
Favorable ratings on visual side effects
Subjective ranking of visual experience
(random blind comparison): n=48

AT LARA produces less visual side effects

compared to a trifocal IOL

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AT LARA 829
Excellent contrast sensitivity in the normal range

2,5
CS [log CS]

ZEISS AT LARA
2,0
J&J Symfony EDoF IOL
Oculentis LENTIS Comfort
1,5 ZEISS CT ASPHINA

1.0

0.5

0 5 10 15

Spatial frequency [cyc/deg]

AT LARA produces excellent Contrast Sensitivity

for most of the spatial frequencies

NEW AT LARA toric 929MP/M

▪ Toric EDoF IOL with wide range of focus and reduced visual side effects, as
AT LARA 829MP
▪ Precise astigmatism correction
▪ Proven rotation stability
▪ Available range:
• AT LARA toric 929MP*:
• SE: -8.0 D to +32.0 D
• CYL: +1.0 D to +4.0 D
• AT LARA toric 929M*:
• SE: -4.0 D to +32.0 D
• CYL: +4.5 D to +12.0 D
• in 0.5 D increments, respectively

•* Further preselected SE/cylinder combinations are available above and below the stated SE range.

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AT LARA toric 929MP/M

Excellent Optical Quality - Bitoricity

• Bitoric designs by default provide an excellent quality image, also in high
cylinder values, leading less aberrations

• Its design also enables production of higher cylinder powers

AT LARA toric 929MP/M

• Easy to use – 4-Haptic design

• In comparison to IOLs with C-loop haptics, the ZEISS 4-haptic lens
design provides the ability to fine tune the axis alignment in both
directions allowing for more efficiency in surgery

Rotation of IOL with C-loop haptics vs ZEISS 4-haptics design.

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AT LARA toric 929MP/M

Calculation
• Reliable and accurate calculations
• We recommend to choose from the following options for calculation:
• IOLM700 (Haigis Suite; Barrett Suite; new TK)
• ZEISS MED IOL Calculation Service @ [email protected]
• Z CALC 2.0 (October 2018)

AT LISA TRI IOL

• With its trifocal platform AT LISA tri IOL brings
multifocal optic design to a complete new level:

– achieving outstanding visual results

– meeting highest expectations of cataract, presbyopia
and astigmatism patients
– offering your patients a whole new sensation of almost
total spectacle independence
This sensation describes not only excellent visual outcomes, but also a feeling of vision
continuity within the whole vision range at almost all distances.
It allows patients to live an active life without glasses and enjoy a full spectrum of activities
without limitations.

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AT LISA TRI & TRI TORIC IOL

– Additional third focal point for real intermediate vision

– Excellent optical efficiency – day and night
• Asymmetrical light transmittance
• Pupil size independency
• Reduced visual phenomena
– Precise astigmatism correction with ZEISS AT LISA tri toric

AT LISA TRI & TRI TORIC IOL

• The superior intermediate vision with ZEISS AT LISA tri family becomes evident when
compared to an apodized bifocal IOL or a trifocal IOL with convolution design.

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AT LISA TRI & TRI TORIC IOL

• Intermediate addition of +1.66, and near addition of +3.33,

to perform most daily activities.

AT LISA TRI & TRI TORIC IOL

Smooth transition between near, intermediate and far vision

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AT LISA TRI & TRI TORIC IOL

Optical design provides high resolution images with very good contrast
sensitivity at all distances and under a wide range of light conditions.

AT LISA TRI & TRI TORIC IOL

• Overall light transmittance

• The refractive-diffractive profile designed to

enhance intermediate vision over the central
optic of the ZEISS AT LISA tri increases the
overall efficiency of light transmittance to an
average rate of:

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AT LISA TRI & TRI TORIC IOL

• Asymmetrical light distribution

• Asymmetrical light distribution of 50 %, 20 % and 30 % between far,

intermediate and near foci, with pupil independenceprovide more
satisfying and predictable visual outcomes for younger patients with active
pupils.

AT LISA TRI & TRI TORIC IOL

The maximized, pupil-independent design

ensures consistent
optical performance regardless of the
lighting conditions.

Optic with trifocal center and bifocal periphery

ensures
optimized night vision.

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AT LISA TRI & TRI TORIC IOL

Utilizing Smooth Micro Phase (SMP)

Technology the ZEISS AT LISA tri optic
does not have any sharp angles,
resulting in
improved optical image quality with
reduced light scattering.

AT LISA TRI TORIC IOL

Equiconvex bitoric optic improves the optical performance of the lens.

• Clear axis marks on the posterior side of the

ZEISS AT LISA tri toric, as well as the 4-haptic
design and a non-sticky IOL surface enable
an easy bi-directional alignment.

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AT LISA TRI & TRI TORIC IOL

• In addition to its square edge design, the ZEISS AT LISA tri & Tri TORICA
also offer a 360 degree anti-PCO barrier for double PCO (Posterior
Capsular Opacification) protection.

AT LISA TRI IOL

Technical Specifications

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AT LISA TRI TORIC IOL

Technical Specifications

EDoF IOL AT LARA vs TRIFOCAL IOL AT LISA TRI

AT LARA Family AT LISA tri family

(AT LARA 829 & AT LARA toric 929) (AT LISA tri 839 & AT LISA tri toric 939)
Extended Depth of Focus (EDoF) IOL Trifocal IOL
VA VA
Spectacle independence from far Maximal spectacle
to intermediate distances. independence
Less visual side effects at all distances
D I N D I N

Patients with an active lifestyle more sensitive Patients with a strong desire to
to side effects and accepting reading glasses get rid of glasses entirely

Surgeons have more options to adapt the IOL according to patients needs

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CORNEAL SURFACE POWER DISTRIBUTION

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CORNEAL SURFACE POWER DISTRIBUTION

CORNEAL ASPHERICITY

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EDoF IOL AT LARA & TRIFOCAL IOL AT LISA TRI

MIX & Match

Results: Halo and Glare Simulator

•N = 9 Minimum - Halo: (8%, 27%) Glare: (0%, 0%)

Halo and Glare values

•Minimal value: 17,44 %
•Maximal value: 62,16 %
•Median: 39,20 % Mean - Halo: (40%, 44%) Glare: (19%, 18%)

•Mean: 40,54 %

Maximum - Halo: (69%, 61%) Glare: (64%, 50%)

EDoF IOL AT LARA & TRIFOCAL IOL AT LISA TRI

MIX & Match

Defocus Curve 6-12 months postop

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EDoF IOL AT LARA & TRIFOCAL IOL AT LISA TRI

MIX & Match

Visual Acuity Results

EDoF IOL AT LARA & TRIFOCAL IOL AT LISA TRI

MIX & Match
Enhancing depth of Focus
Aberration neutral

• AT LARA Distance 105 cms 55 cms

CONTINIOUS VISION

• AT LISA TRI Distance 80 cms 40 cms

Sharp Focus
Correction of Spherical
aberration (-0,18)

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Muchas
¡¡Muchas Gracias!! Gracias

¡ Muchas Gracias !

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