Prevalence of Astigmatism
It has been proven that astigmatism is more prevalent than expected among cataract patients. High prevalence of corneal astigmatism has been reported in many research articles. After toric implantation, residual postoperative corneal astigmatism of 0.75 D or lower may improve uncorrected visual acuity and reduce symptomatic blur, ghosting of images, and halos. (1)
40% of Cataract Patients Exhibit ≥1.0 D Astigmatism
The study published by Ferrer-Blasco T et al. in 2009, consisting of 4540 patients with cataract showed corneal astigmatism to be prevalent in 87% of patients. (2)
Another clinical study of 5987 cataract patients performed by Dr. Warren Hill, reported that 52.5% of patients had preoperative astigmatism of more than 0.75 D. The figure above shows the percentage of patients at various levels of preoperative Astigmatism. (3)
Clear Vision for Astigmatic Patients
You can make more patients happy. Patients will begin enjoyable life after surgery with clear vision and spectacle independence. AcrivaUD Toric has the largest diopter range in the astigmatism correcting IOLs which is defining as Custom Made Perfection. Spherical power starts from 0.00D to 32.00D and cylinder power range is available up to 10.00D with half diopter increments.
Clinical Outcomes
Minimum Residual Astigmatism
Acriva demonstrates outstanding performance with only 0.3 D residual astigmatism in a clinical study performed with 26 patients. Also, there was no residual astigmatism after 3-month follow-up for 57.6% of patients. (4)
Excellent Rotation Stability
The same study also presented that AcrivaUD Toric had an excellent rotation stability in the capsular bag. Based on the mean axis deviation, 84% of all eyes had less than 3° rotation and all patients had less than 5° rotation after surgery. (4)
Clinical Outcomes
Minimum Residual Astigmatism
Best Solution is Plate Haptic
Larger incision causes itself surgically induced astigmatism and directly effects post-operative refractive outcomes. AcrivaUD Toric Plate haptic is the best choice platform enables implantation through sub 2.0 mm incision, it can minimize surgically induced astigmatism and stays in capsular bag without rotation.
Alignment of the AcrivaUD Toric lens in both side makes easier rotation during operation. It is always excellent rotational stability seen with plate haptic design as toric IOL hold on to posterior capsular bag in four points.
Plan Your Surgery
Amount and Axis of Astigmatism
Successful toric implantation starts with precise examination and evaluation of the amount and axis of corneal astigmatism. Selection of an ideal patient for toric application keratometry, biometry, pupillometry, aberrometry, videokeratoscopy or any other devices are recommended to use as a preoperative diagnostic evolution.
Measurements should be repeated under suitable conditions if big differences are found among different methods. Determine the axis of astigmatism is equally important with its amount which involves directly outcomes after implantation. Regular astigmatism should be assured by checking topographic map of the cornea.
Inclusion Criteria
Optimum postoperative results are based on correct patient selection. Recommended inclusion criteria should be followed in a preoperative toric surgery plan. Total astigmatism of the eye is the value measured in routine clinical practice which includes both cornea-dependent external astigmatism and neutral lens-dependent internal astigmatism. Only external astigmatism must be taken into consideration in toric IOL calculation since the lens is removed during surgery. (5)
Recent studies have shown the importance of considering the posterior corneal surface when determining total corneal astigmatism and planning astigmatism correction. The posterior cornea acts as a minus lens and it should be evaluated during pre-operative planning. (6-7)
Acriva Easy Toric Calculator
AcrivaUD Easy Toric Calculator is developed to assist you easily planning your surgery and helping you reach precious toric outcomes.
You can access the AcrivaUD Easy Toric Calculator by visiting www.vsybiotechnology.com and you can download the application available for iPhone and iPad from the Apple Store and for all devices link to android market.
For more information AcrivaUD Easy Toric Calculator’s User Guide.
Marking The Eye
Preoperative Marking
Preoperative reference marking is recommended in the patient’s sitting position to limit cyclotorsional effect the eye exposed when switch from vertical to horizontal position. Mark a reference axis, ideally with the help of slit lamp, with a marking pen or ink pad. Slit lamp may also be used for targeted axis by changing lamp position to desired angle or axis marking may be done in conjunction with preop markers.
Intraoperative Marking
After changing patient sitting position to supine position, mark the targeted axis with fixation rings as Mendez with the guide of reference point. Pendulum markers is another option in which gravity allows the precious marking. Accurate axis marking is crucial in toric implantation as in case of rotational misalignment can be result of no cylindrical correction.
Light Filtration – Efficient Photoprotection
Optimum Filtration Range – Balanced Photoprotection of UVA and Violet Spectrum
AcrivaUD BB provides excellent photoprotection from potential damage of the UVA and violet spectrum without blocking blue light. AcrivaUD BB ensures 95% blue light transmission at 480 nm which is known as critical in controlling the circadian rhythm
The choromophore used in AcrivaUD BB material is the same chromophore as in the human natural lens which gives similar transmission structure as a young human lens.
Importance of Blue Light
Blue light plays a crucial role in controlling the circadian rhythm and endogenous melatonin secretion. Disorganisation of the circadian rhythm is more common in older adults and people with insomnia, depression and dementia. Blue-blocking IOLs which contain synthetic dye filter up to 500 nm causes excessive filtering of blue light.
Natural Chromophore – Same Transmission Properties than Natural Lens
AcrivaUD BB contains 3-hydroxykynurenine which is exactly the same as in our natural lens.
Chromophore structure of AcrivaUD possesses the same transmission as a human natural crystalline lens with a good protection of the macula against UV-A and blue light thanks to the absorption curve which mimics the human crystalline lens, preserving the natural color perception and contrast sensitivity.
Ideal Concentration – Improved Contrast Sensitivity
AcrivaUD BB’s chromophore concentration is 0.02%. It has a clearer color in comparison to IOLs with higher concentrations of chromophores. Low concentration of AcrivaUD BB does not influence color perception of the patient. Natural chromophore and its lower concentration provide a higher contrast sensitivity under low light condition.
360° All Enhanced Square Edge
Real PCO Barrier
The innovative edge design tends to greatly reduce PCO risk by forming a geometric and mechanical barrier against cells proliferation. The edge design produces thinner lenses for equivalent power than competitors.
Exceptional Design
360° All Enhanced Square Edge and premium material form a dual barrier against the risk of posterior capsule opacification after implantation. Recent studies have shown that square edge on posterior surface of the optic is the most important IOL-related factor against PCO formation.
Ultra Definition
Ultra Definition optic design corrects spherical aberrations coming from both cornea and IOL. However, AcrivaUD IOLs have a slight negative asphericity, which maintains part of the positive aberration of the cornea, helping patient to keep better depth of focus.
Advantage of Ultra Definition Design
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Improved contrast sensitivity under low light condition
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Preserved depth of focus
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Less sensitive to decentration
Premium Material
Best of Both Worlds!
Excellent material combination of 2-Oxiethylmethacrylate and 2-Hydroxymethacrylate monomers creates hydrophobic surface behavior with the advantage of hydrophilic flexibility.
Proven Hydrophobic Surface Behavior
AcrivaUD has similar contact angle measurements similar to pure hydrophobic IOLs. An independent comparative study showed that the hydrophobic surface of AcrivaUD is similar to that of pure hydrophobic competitors.
Benefits of Hydrophobic and Hydrophilic Monomers
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No glistening
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Limited PCO
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High biocompatibility
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Low inflammatory response
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No calcification
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Easy to fold and inject
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MICS capability
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Quickly unfolding in the eye
Better Flexibility
The elastic co-polymer of AcrivaUD has precise memory. Point Spread Function (PSF) shows that the optic quickly recovers its initial shape within one hour, much quicker than hydrophobic IOLs.
Wide Diopter Range
Complete Solution
AcrivaUD toric has a wide diopter range
Spherical power: 0.00 D to +32.00 D, in 0.50D increments.
Cylindrical power: 1.00 to +10.00 D, in 0.50D increments.
Special production: -20.00D to 0.0D and from +32.00D to +45.00D in 0.50D increments.
Superior Chromatic Aberration Control
Clear Vision
Abbe Number of AcrivaUD is 58, one of the highest numbers in the IOL market, measured by independent laboratory. Superior chromatic aberration control in all AcrivaUD lines.
The Importance of Abbe Number
Chromatic aberration is type of distortion in optical system formed by different wavelengths of light to have different focal points. The higher the Abbe number is the lower the chromatic dispersion is.
High MTF Values
Better Visual Quality
The MTF of all AcrivaUD lenses is checked one by one and value is always above international standards limits. AcrivaUD products demonstrates superior MTF and smooth surface topography, thanks to our innovative optic engineering
Modular Transfer Function
MTF is a direct and quantitative measurement of optic system quality. The best result through obstacles is 0.7 at 100 lpm. According to international standards the MTF result at an IOL must be above 0.43 at 100 lpm3.
VSY Biotechnology has determined its own quality control limits far stricter than international standards.