The 2014 annual meeting of the American Society of Cataract and Refractive Surgery in Boston came to a close last week. The following is my top 10 new product list from this year’s conference:
Toric ICL from Staar Surgical: This lens recently received an FDA panel recommendation for approval. This is an encouraging sign for U.S. surgeons who have been awaiting this technology for years. Unfortunately, the TICL will not have the new V4c CentraFLOW design that enables implantation without iridotomies.
Intracorneal inlays are a promising treatment for presbyopia. Although these implants are not yet FDA approved, the Kamra from AcuFocus, Flexivue Microlens from Presbia, and Raindrop Near Vision Inlay from ReVision Optics have all demonstrated efficacy in clinical studies.
AcuTarget HD Analyzer from AcuFocus: This comprehensive diagnostic device for the surgical treatment of presbyopia is designed to optimize outcomes for corneal inlay surgery as well as for pre- and post-operative assessment for cataract and refractive patients. The instrument provides a wealth of information including the location of the 1st Purkinje image (x and y coordinates), objective scatter index (OSI) and point spread function which are measures of quality of vision, predicted visual acuity, depth of focus, and modular transfer function. This data is important for patient selection as well as evaluating the inlay position postoperatively.
CustomFlex Artificial Iris from HumanOptics: This silicone prosthesis is used for visual and cosmetic rehabilitation in patients with significant iris defects (i.e., complete or partial aniridia). It is custom made to match the appearance of the patient’s fellow eye. Although not FDA approved, it has been used under compassionate use exemptions in the US with impressive results.
Femtosecond Laser Cataract Systems: These systems continue to evolve. One newer system, the Femto LDV Z8 from Ziemer, is a mobile platform for refractive and cataract surgery, but it is not yet cleared by the FDA. The systems available in the U.S. are the LenSx Laser from Alcon, the Catalys Precision Laser System from AMO/OptiMedica, the LensAR Laser System from LensAR, and the Victus Femtosecond Laser Platform from Bausch + Lomb/Technolas. Recent improvements include the SoftFit interface and new software with grid fragmentation pattern for Alcon’s LenSx, and the smaller diameter LiquidOptics interface and a software upgrade for faster workflow and treatment for the Catalys system from AMO/OptiMedica.
Advanced Phaco Fluidics Incorporated into Phaco Machines: The Centurion Vision System from Alcon was created to optimize cataract surgery. It contains Active Fluidics to improve chamber stability and maintain a target IOP by automatically monitoring and adapting to the intraocular conditions. The Stellaris PC with StableChamber Fluidics from Bausch + Lomb provides precise control of fluidics for a safer procedure.
HOLOS IntraOp from Clarity Medical Systems: This intraoperative wavefront aberrometer attaches to the surgical microscope and displays real-time streaming refractive measurement data throughout the surgery. The device is still in development but will join the ORA VerifEye from WaveTec as the second intraoperative aberrometer.
Integration of advanced ophthalmic technologies is being utilized by a number of companies. Alcon was the first to integrate some of their devices to form the Cataract Refractive Suite, which allows for seamless transfer of information among instruments. Specifically, the suite is composed of the Verion image guided system, LenSx laser, Luxor LX3 microscope, and Centurion phaco machine. Recently, LensAR signed agreements with both I-Optics and TrueVision 3D which will eventually enable the capture and wireless transfer of information between the Cassini Corneal Topographer, LensAR laser system, and TrueGuide system. Additionally, TrueVision 3D and Leica have announced an alliance to combine computer guidance with ophthalmic microscopes.
ReSure Sealant from Ocular Therapeutix: This material received FDA approval in January for sealing clear corneal cataract incisions that are Seidel positive. This is a much anticipated alternative to traditional sutures to provide a watertight seal. It is quick and easy to apply, comfortable for the patient, and does not need to be removed postoperatively.
IOL delivery systemsare becoming more user friendly, and now preloaded and automated injector systems exist. The preloaded systems, which are not available in the U.S., include the iSert from Hoya, Tecnis iTec from AMO, and AcrySert C from Alcon. The Intrepid AutoSert injector from Alcon is an automated system that works with the Infiniti and Centurion phaco machines. The Bausch + Lomb Injector System (BLIS) is another automated IOL injector system. It is designed for use with the enVista IOL and can deliver the lens through a 2 mm incision.
These are some of the most exciting innovations on their way to American practices. Did I miss anything new and exciting? If so, let us know in the comments below.