Acriva Reviol BB T MFM 611
- Prevalence of Astigmatism
- Clinical Outcomes
- Best Solution is Plate Haptic
- Plan Your Surgery
- Active Diffractive Optic
- Light Filtration- Efficient Photoprotection
- 360° All Enhanced Square Edge
- Ultra Definition
- Premium Material
- Wide diopter range
- Superior Chromatic Aberration Control
- High MTF Values
Prevalence of Astigmatism
Prevalence of astigmatism is much more than expected among cataract patients. High prevalence of corneal astigmatism has been reported in many different articles. After toric implantation, residual postoperative corneal astigmatism of 0.75D or lower may improve uncorrected visual acuity and reduce symptomatic blur, ghosting of images and halos1.
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 patients2.
Clear Vision for Astigmatic Patients
Minimum Residual Astigmatism
Clinical study of AcrivaUD Toric included 26 patients demonstrated that only below
0.3D residual astigmatism have been reported in all patients and there were no residual astigmatism in 57.6% of patients after 3 months follow-up.
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 surgery3.
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 2.0mm 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, videokeratoskopy 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.
Optimum post-operative results are based on correct patient selection and recommend inclusion criteria should be followed in pre-operative 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 kept consideration in toric IOL calculation since lens is removed during surgery4.
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 5,6.
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 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.
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.
Not all diffractive IOLs are the same. The unique design of Reviol’s Active Diffractive zones provides excellent light transmission at maximum range under any light condition
Diffractive Zones of Reviol
The performance of multifocal IOLs is based on their establishment of diffractive zones. The different number, height, interval and width of the rings affect patient total visual outcomes under lower light conditions. Diffractive multifocal IOL engineering is based on balanced light energy between foci. Narrow rings increase the near addition. Conversely higher steps enable the transfer of more energy to near focus1.
Pupil Independent Light Transmission – Increased Contrast Sensitivity
Reviol’s Active-Diffractive optic preserves a better balance of 60% far and 40% near focus at 6mm pupil aperture. Balanced light distribution under any light condition increases contrast sensitivity.
Decreased contrast sensitivity in mesopic light condition has been reported in pupil dependent multifocal IOLs . This phenomenon is explained by a light distribution change of 90% for far focus and 10% for near focus at 6mm pupil diameter. The lower energy transfer to near focus causes poor visual acuity in the patient.
3,75D Near Addition – Improved Intermediate Vision
3.75D near addition in Reviol’s Active-Diffractive Optic has the appropriate balance to provide better intermediate visual acuity. Near addition is crucial in energy distribution through near to distance focus. Insufficent near addition results in inadequate disparity between foci, which causes blurring vision at intermediate focus. Excessive near addition eliminates focus overlapping and provides sharp near and distance vision. On the other hand reduced visual performance may result, which causes difficulties in patient adaptation.
Visual Performance After Implantation – Enhanced Visual Acuity For All Distances
In the results of defocus curve graphic, Reviol’s Active-Diffractive optic has better intermediate vision than Apodized +4.0D multifocal IOLs, and better near visual performance in comparison with Apodized +3.0D multifocal IOLs.
The defocus curve was determined in a comparative study on 130 eyes of 87 patients and included a comparison with Reviol +3.75D near addition, an apodized multifocal IOL +3.0D near addition and an apodized multifocal IOL +4.0D near addition.
Ring Transition Zones – Limited Photopic Phenomena
Reviol’s progression zones are rounded in a unique manufacturing process.
Exceptional Optic Engineering – Square Edge and Aspheric Design
Reviol’s enhanced 360° square edge and premium material form a dual barrier against PCO formation after implantation. The aspheric design of the Reviol “UD technology”, compensates for the positive spherical aberration of the cornea while preserving depth of focus.
Recent studies concluded that a square edge on the posterior optic surface is the most important IOL-related factor against PCO formation. According to different experimental studies, this may be due to the mechanical barrier effect exerted by the square edge.
Depth of Focus
Corneal topography measurements on 71 cataract patients have shown that average spherical aberration of the human cornea is +0.27 microns. With spheric IOL implantation total ocular spheric aberration becomes increasingly positive. Poor contrast sensitivity has been reported in many postoperative cataract patients after implantation of spheric IOLs.
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 480nm 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 doesn’t 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.
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 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
- Improved contrast sensitivity under low light condition
- Preserved depth of focus
- Less sensitive to decentration
Superior Chromatic Aberration Control
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.
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
- No glistening
- Limited PCO
- High biocompatibility
- Low inflammatory response
- No calcification
- Easy to fold and inject
- MICS capability
- Quickly unfolding in the eye
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
AcrivaUD Reviol Toric has a wide diopter range
Spherical power: 0.00D to +32.00D, in 0.50D increments.
Cylindrical power: 1.00 to+10.00D in 0.50D increments.
Special production: +32.50 D to +45.00 D, in 0.50 D increments
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.