Abstract
Purpose of Review
The purpose of this review is to explore the visual and refractive outcomes, incidence of photic phenomena, contrast sensitivity, and patient satisfaction outcomes of Tecnis Symfony extended depth of focus (EDOF) IOL from the peer-reviewed literature, conference presentations, and personal experience.
Recent Findings
This presbyopia-correcting EDOF IOL has a unique optical design providing an elongated area of focus which aims to enhance intermediate and near vision, while providing good contrast sensitivity and low rates of photic phenomena. Clinical defocus curves show a 1.0 D increased depth of focus compared to a monofocal lens and maintenance of 20/25 or better visual acuity throughout 1.5 D of defocus.
Summary
The available data suggest that Tecnis Symfony EDOF IOL is a promising option for patients seeking a functional range vision with minimal compromise in quality of vision.
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References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Montes-Mico R, Espana E, Bueno I, Charman WN, Menezo JL. Visual performance with multifocal intraocular lenses: mesopic contrast sensitivity under distance and near conditions. Ophthalmology. 2004;111(1):85–96. doi:10.1016/S0161-6420(03)00862-5.
•• TECNIS Symfony® Extended Range of Vision IOL, Z311036, Rev. 02. [package insert]. Santa Ana, CA, Abbott Medical Optics, Inc., Revision Date: 09/2016. Available at: http://www.tecnisiol.com/us/media/pdf/symfony/US%20Only_Z311036_02.pdf. Accessed April 19, 2017. FDA clinical trial compared clinical outcomes in a large series of Tecnis Symfony extended range of vision IOL (294 eyes) and Tecnis monofocal IOL (296 eyes).
Chang DH, Weeber HA, Lowery M, Piers P. Chromatic aberration of intraocular lenses measured in vitro and in vivo. Invest Ophthalmol Vis Sci. 2016;57(12):3110.
Negishi K, Ohnuma K, Hirayama N, Noda T. Policy-Based Medical Services Network Study Group for intraocular L, refractive S. Effect of chromatic aberration on contrast sensitivity in pseudophakic eyes. Arch Ophthalmol. 2001;119(8):1154–8.
Terwee T, Weeber H, van der Mooren M, Piers P. Visualization of the retinal image in an eye model with spherical and aspheric, diffractive, and refractive multifocal intraocular lenses. J Refract Surg. 2008;24(3):223–32.
Weeber HA, Piers PA. Theoretical performance of intraocular lenses correcting both spherical and chromatic aberration. J Refract Surg. 2012;28(1):48–52. doi:10.3928/1081597X-20111103-01.
Zhao H, Mainster MA. The effect of chromatic dispersion on pseudophakic optical performance. Br J Ophthalmol. 2007;91(9):1225–9. doi:10.1136/bjo.2007.118745.
Rocha KM. Extended depth of focus IOLs: the next chapter in refractive technology? J Refract Surg. 2017;33(3):146–9. doi:10.3928/1081597X-20170217-01.
Barisic A, Gabric N, Dekaris I, Romac I. Clinical outcome after implantation of the Tecnis Symfony extended range of vision IOL. XXXIII Congress of the ESCRS; September 5–9 Barcelona, Spain 2015.
•• Cochener B, Concerto Study G. Clinical outcomes of a new extended range of vision intraocular lens: International Multicenter Concerto Study. J Cataract Refract Surg. 2016;42(9):1268–75. doi:10.1016/j.jcrs.2016.06.033. Key article that evaluated the clinical outcomes with Tecnis Symfony extended depth of focus IOL using two approaches: intended micro-monovision in one group and bilateral emmetropic targeting in the other group.
Hamid A, Sokwala A. A more natural way of seeing: visual performance of three presbyopia correcting intraocular lenses. Open Journal of Ophthalmology. 2016;6(03):176.
Howes F, Howes L, Du Rieu M. TECNIS® Symfony extended-range-of-vision intraocular lens. XXXIV Congress of the ESCRS; September 10–14 Copenhagen, Denmark 2016.
Lee H. Evaluation of TECNIS® Symfony extended-range-of-vision intraocular lens (IOL): a 6-month clinical outcome. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
• Pedrotti E, Bruni E, Bonacci E, Badalamenti R, Mastropasqua R, Marchini G. Comparative analysis of the clinical outcomes with a Monofocal and an extended range of vision intraocular lens. J Refract Surg. 2016;32(7):436–42. doi:10.3928/1081597X-20160428-06. This study presented the 3-month clinical outcomes following bilateral implantation of Tecnis monofocal and Tecnis Symfony extended range of vision IOL. Study also evaluated optical quality parameters like modulation transfer function, Strehl ratio, Ocular Scattering Index etc.
Podboraczynska-Jodko K, Lubinski W, Kirkiewicz M. Clinical outcomes after cataract surgery with implantation of the multifocal Tecnis Symfony lenses. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
Gundersen K. Visual performance with an extended-range-of-vision toric intraocular lens. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
Law E, Aggarwal R, Kasaby H, Buckhurst P. Comparison of the AT LISA 839MP trifocal IOL and the Technis Symfony IOL. 20th ESCRS Winter Meeting; February 26–28; Athens, Greece 2016.
Auffarth G. Clinical Experience With Extended Range of Vision 1-Piece IOL. 2015 ASCRS ASOA Symposium and Congress; April 17–21; San Diego, United States: Ascrs; 2015.
Krizova D, Studeny P, Kuchynka P. Early clinical experience with an IOL with extended range of vision. XXXIII Congress of the ESCRS; September 72015.
Vergamota A, Silva J, Carapinha C, Batista J, Marques C. Comparative study of visual function after implantation of 2 different IOLs: tri 839MP (trifocal) and ZXR00 (extended-range-of-vision). XXXIV Congress of the ESCRS; September 10–14; Copenhagen, Denmark 2016.
Monteiro T, Lemos J, Neves MC, Vaz F. Comparative study of visual and refractive outcomes between a low-add diffractive multifocal and an extended-depth-of-focus multifocal intraocular lenses. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
Spyra M, MrukwaKominek E. Binocular visual outcomes at all distances with new extended-range-of-vision intraocular lenses Tecnis Symfony implanted in micro-monovision configuration. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
Mesa RR, Pastor-Pascual F. Reading Ability With New Extended Range of Vision 1-Piece IOL. 2015 ASCRS ASOA Symposium and Congress; April 17–21; San Diego, United States 2015.
166 Data on File_Extended Range of Vision IOL 3-Month Study Results (NZ).
Nguyen P, Hirnschall N, Findl O. Visual performance and rotational stability after the bilateral implantation of a TECNIS® symfony Toric extended range of vision intraocular lens. 20th ESCRS Winter Meeting; Athens, Greece 2016. p. February 26–8.
Goslings W, Vandemortel E. Femto laser-assisted cataract surgery (FLACS) with implantation of the AMO Tecnis Symfony and Symfony toric IOL. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
Kasthurirangan S, Buteyn A, Murray NL, Corbett D. Early Visual Outcomes With Toric Extended Range of Vision IOL. 2015 ASCRS ASOA Symposium and Congress; April 17–21; San Diego, United States 2015.
Breyer DR, Kaymak H, Klabe K, F.T. Kretz, Auffarth GU. Evaluation of New Aberration-Correcting Extended Range of Vision PCIOL for Micromonovision to Correct Presbyopia After Cataract and Refractive Lens Surgery. 2015 ASCRS ASOA Symposium and Congress; April 17–21 San Diego, United States 2015.
Kılıç A. Will Enhanced Depth-of-focus Intraocular Lenses Lead the Future in Premium Lenses? European Ophthalmic Review. 2015.
Hamid A, Sokwala A. Visual performance of the Symfony IOL in patients who have had prior laser refractive surgery. 20th ESCRS Winter Meeting; February 26–28; Athens, Greece 2016.
Castillo-Gomez A, Carmona-Gonzalez D, Martinez-de-la-Casa JM, Palomino-Bautista C, Garcia-Feijoo J. Evaluation of image quality after implantation of 2 diffractive multifocal intraocular lens models. J Cataract Refract Surg. 2009;35(7):1244–50. doi:10.1016/j.jcrs.2009.02.024.
Lee H, Lee K, Ahn JM, Kim EK, Sgrignoli B, Kim TI. Double-pass system assessing the optical quality of pseudophakic eyes. Optometry and vision science : official publication of the American Academy of Optometry. 2014;91(4):437–43. doi:10.1097/OPX.0000000000000190.
Lee H, Lee K, Ahn JM, Kim EK, Sgrignoli B, Kim TI. Evaluation of optical quality parameters and ocular aberrations in multifocal intraocular lens implanted eyes. Yonsei Med J. 2014;55(5):1413–20. doi:10.3349/ymj.2014.55.5.1413.
Kamiya K, Umeda K, Kobashi H, Shimizu K, Kawamorita T, Uozato H. Effect of aging on optical quality and intraocular scattering using the double-pass instrument. Curr Eye Res. 2012;37(10):884–8. doi:10.3109/02713683.2012.688164.
Black S. Combining an extended depth of focus IOL with a low-add multifocal IOL to extend patient's functional vision. 2016 ASCRS ASOA Symposium and Congress; May 6–10; New Orleans, United States 2016.
• Black S. Successful restoration of visual acuity with an extended range of vision intraocular lens after multifocal laser ablation. Case Reports in Ophthalmology. 2016;7(3):193–7. This case report provided evidence for the suitability of implanting Tecnis Symfony extended range of vision IOL in a patient with previous multifocal ablation excimer laser surgery.
Barisic A, Gabric N, Dekaris I, Romac I. Tecnis Symfony extended-range-of-vision IOL in cataract surgery after laser refractive surgery. XXXIV Congress of the ESCRS; September 12; Copenhagen, Denmark 2016.
Neves P, Matias I, Santos M, Martins D. Enlarged depth-of-focus IOLs for post-radiation therapy cataract surgery: review of 2 clinical cases. XXXIV Congress of the ESCRS; September 10–14 Copenhagen, Denmark 2016.
Scott MC. Conference Paper. Caribbean Eye 2017; Cancun, Mexico.
Piers PA. Tolerance to refractive errors of a new technology for extending range of vision. XXXII Congress of the ESCRS; 13 September; London, UK 2014.
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Jan Beiting (Wordsmith Consulting, Cary, North Carolina) provided writing and editing assistance.
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Ron Baldassare reports personal fees from Abbott Medical and is a consultant to AMO, outside the submitted work.
Raman Bedi reports personal fees from AMO, personal fees from TearScience, AMO, and Cassini, outside the submitted work.
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This article contains no studies with human or animal subjects performed by the authors.
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This article is part of the Topical Collection on Refractive Surgery: From Laser to Intraocular Lenses
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Baldassare, R., Bedi, R. Symfony Extended Depth of Focus IOL: a Review of Reported Data. Curr Ophthalmol Rep 5, 225–231 (2017). https://doi.org/10.1007/s40135-017-0143-2
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DOI: https://doi.org/10.1007/s40135-017-0143-2