Monofocal innovation

J&J Vision sees new cataract standard of care with intermediate 
vision-improving IOL

Howard Larkin

Posted: Monday, April 1, 2019

Tecnis Eyhance monofocal IOL

The new Tecnis Eyhance monofocal IOL delivers, says Jean-Claude Dubacher, the firm’s regional vice president for surgical vision in Europe, the Middle East and Africa.
Eyhance provides the clear distance vision and high contrast sensitivity of a traditional monofocal IOL while extending depth of focus for functional intermediate vision. This enables many patients to perform daily tasks such as walking on uneven surfaces, driving and even reading price tags while shopping.
“It’s really about changing the standard of care. Since the introduction of the foldable lens and aspheric lenses in the early 2000s there hasn’t really been much innovation on the monofocal side. This lens really makes a difference for the patient,” Dubacher said.
Launched this year across Europe, Eyhance is covered by many health plans, making it easily affordable for patients, though arrangements vary, Dubacher added. “This is not a lens in the private-pay, premium IOL space. It is a monofocal innovation targeting the vast majority of cataract patients.”

Easy adoption, 
enhanced outcomes
Eyhance extends depth of focus using 
a higher-order asphere in the optic centre that blends into the optic zone and periphery without rings. Data has shown low incidence of glare, halo or starbursts comparable to what has been reported with the Tecnis 1-piece IOL on which it is based.
As a result, Eyhance can be easily substituted for a traditional monofocal Tecnis lens, requiring no change in biometry, power calculation or surgical technique, said Oliver Findl MD, of Hanusch Hospital, Vienna, Austria.
If anything, Eyhance gives better results in cases with minor refractive misses due to biometry errors or healing variation than traditional monofocal IOLs, said Dr Findl, who has implanted the lens in about 30 patients. “We have noticed the lens has a larger sweet spot and a higher probability of achieving good visual acuity.”
Indeed, many of Dr Findl’s early patients have achieved 20/16 distance vision uncorrected, he reported. Most also have good intermediate vision, with intermediate vision outcomes generally better in patients who precisely hit the distance refractive target. Glare, haloes and night vision results are similar to standard monofocal IOLs.
So far, patients have been very satisfied with visual outcomes, with many pleasantly surprised at the quality of intermediate vision, Dr Findl said. To further enhance unaided vision, he is experimenting with combining Eyhance with micro-monovision, targeting emmetropia dominant and about -0.5D non-dominant. “I would expect these 
people to have good intermediate vision 
and even some near vision with good lighting, holding the reading card a little farther away.”
Dr Findl finds the advantages of Eyhance compelling enough that he is adopting it as his standard monofocal lens. “It is a more forgiving monofocal lens if you use it as such and don’t promise the patient too much.”

Moving the 
refractive market
Eyhance is just the first in a range of innovations that Johnson & Johnson Vision intends to elevate the standard of eye care, Dubacher said. In keeping with a statement of purpose adopted when it acquired its surgical vision operations two years ago, the firm has a rich pipeline of products that are intended to protect and improve eye health, he added.
“For the next generation we want to change the standard of care. We want to lead with innovations that really change outcomes, that make a difference in patients’ and surgeons’ lives. Having an innovation in monofocal IOLs is exciting; the market is very different than that for premium IOLs. Think of the millions of people you can reach. We are very excited about that,” Dubacher added.