Andrea Galvis, MD 1 , 3 Ivan Ossma Gomez,MD MPH 1 , 2

1. Long-Term Quantitative Analysis of Posterior Capsule Opacification After Implantation of Dual-Optic Accommodating IOLs Andrea Galvis, MD1 , 3 Ivan Ossma Gomez,MD MPH 1 , 2 1 Fundación Valle del Lili Cali, Colombia 2 Universidad Industrial de Santander Bucaramanga, Colombia 3 Fundación Oftalmológica de Santander Bucaramanga, Colombia Authors are clinical investigators for the Synchrony Dual Optic Accommodating IOL

2. Synchrony Dual Optic Accommodating IOL • Fills the capsular bag • Designed to provide accommodation via forward movement of the anterior optic • Potential for movement could be impaired by capsule opacification • ACO • PCO Galvis et al

3. Clinical Experience Synchrony • Good unaided distance, intermediate and near visual function 1,2,3 • Subjective and objective evidence of accommodative amplitude 4,5,6 • Stability of over 2 years 1,2 • Low PCO rates 7 • Functional range of vision exceeding that of multifocals 8 1 Alarcon et al. ESCRS London 2006 2 Ossma et al. ASCRS San Francisco 2006 3 Beiko G. ESCRS London 2006 4 Ossma et al. ASCRS San Diego 2004 5 Galvis et al. ASCRS Washington 2005 6 Bohorquez et al. ESCRS London 2006 7 Galvis et al. ESCRS Berlin 2008 8 Ossma et al. ASCRS Chicago 2008 Galvis et al

4. Rabbit Studies* Synchrony Plate Haptic IOL • Difference in PCO • Synchrony 0.714 ± 0.751 • Plate haptic IOL 3.142 ± 0.899 • *Werner et al. JCRS 2004; 1114-23 Galvis et al

5. Study Design • Prospective Observational Analytical Study • 3 Groups • Synchrony IOL Implantation (43 eyes) • Alcon SN60D3 (42 eyes) • Alcon SN60AT Implantation (54 eyes) Galvis et al

6. Study Design • Digital retroillumination photographs (3,6,12 and 24 months) • Evaluate incidence PCO • OSCA System • Evaluate incidence ACO • Photography grading one observer Galvis et al

7. OSCA(Open Access Systematic Capsule Assessment) • Aslam et al. ¹-²-³ • Based on texture analysis • Objective • Valid • Reliable ¹ Aslam et al. BMC Ophthalmology 2005, 5:9 ²Aslam et al. BMC Ophthalmology 2006, 6:30 ³ Paton et al. BJO 2002, 86:1181-87 Galvis et al

8. Study Population * Kruskal Wallis Analysis of Variance Galvis et al

9. Results Alcon SN6AD3 21.3 months postop Synchrony 20.7 months postop Alcon SN60AT 21.1 months postop Galvis et al

10. CLINICALLY SIGNIFICANT PCO OSCA Score Evolution p=0.41 p=0.83 OSCA Score p=0.27 p=0.38 Mann-Whitney Test Galvis et al

11. Anterior Capsule OpacificationMonth 12 Fisher’s Exact Test p=0.37 Galvis et al

12. Conclusion • Elements in design of Synchrony Dual Optic Accommodating Intraocular Lens • Minimize ACO • Minimize PCO • Synchrony Dual Optic Accommodating IOL • PCO Rates comparable to those of acrylic monofocal and multifocal IOLs Galvis et al

13. Thank you andreagalvis@mac.com www.perfectavision.com