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Say goodbye to cataracts & astigmatism! Say hello to the forerunner in lens replacement that’s proven and reliable. One simple solution to better vision. Now, one simple procedure can help you regain quality vision – while reducing dependence on eyeglasses or contact lenses. If you have astigmatism, you probably rely on eyeglasses or contact lenses to correct your vision. The problem is, eyeglasses can be easily misplaced or broken, and taking contact lenses in and out can complicate an active, spontaneous lifestyle. If you have been diagnosed with cataracts, one simple outpatient procedure may eliminate your need for eyeglasses or contact lenses -- replacing your clouded cataract lens with an artificial lens designed to correct astigmatism too. The solution is called the STAAR Toric Intraocular Lens (or “IOL”), and it is the first such lens to be approved by the FDA for its effectiveness, safety and reliability. What makes the STAAR Toric IOL such a good choice? The STAAR Toric IOL is a revolutionary, singlepiece foldable lens that your surgeon implants in your eye during cataract surgery. It is specially designed to correct astigmatism, and help you regain quality vision. The STAAR Toric IOL is made from a stable, non-toxic and flexible material the eye comfortably welcomes, providing excellent optical performance and high quality vision. How the eye sees. The eye is a complex organ composed of many small parts, each vital to normal vision. The ability to see clearly depends on how well these parts work together. Light rays reflected off objects enter the eye through the cornea -- the transparent front part of the eye that covers the iris and pupil. Crystalline lens Cornea Pupil Retina Light ray Vitreous Iris reaching the retina. The retina lines the back twothirds of the eye and is responsible for the wide field of vision. For clear vision, light rays must focus directly on the retina. When light focuses in front of or behind the retina, the result is blurry vision. What is a cataract? The eye’s natural crystalline lens is the clear part of the eye that helps focus incoming light rays on the retina to form an image, which is then transmitted to the brain through the optic nerve. The crystalline lens is made primarily of water and protein, allowing the structure to change shape to focus on near and distant objects. A cataract is a painless clouding of the eye’s lens. Since a cataract affects the clarity of the lens, it prohibits the light from passing through the lens easily. This causes the retina to receive blurred or distorted images. Because the brain cannot receive clear images of objects, vision gradually becomes Next, the light rays pass through an opening in the iris (colored part of the eye), called the pupil. The iris controls the amount of light entering the eye by dilating or constricting the pupil. In bright light, for example, the pupil contracts in order to prevent too much light from entering. In dim light, the pupil enlarges dramatically to allow more light to enter the eye. Light then reaches the crystalline lens. The lens focuses light rays onto the retina by bending (refracting) them. The cornea does most of the refraction and the crystalline lens fine-tunes the focus. Behind the lens and in front of the retina is a chamber called the vitreous body, which contains a clear, gelatinous fluid called vitreous humor. Light rays pass through the vitreous before impaired. As a cataract progresses, the possibility of cataract eye surgery should be strongly considered. As a cataract, if left untreated, could lead to blindness. In fact, cataracts are the leading cause of blindness in the world. Cataracts affect nearly 20.5 million Americans age 40 and older1. What is “astigmatism?” Astigmatism is a common condition that may cause blurred vision. The distorted vision is due to the eye’s cornea (corneal astigmatism) or lens (lenticular astigmatism) having an irregular shape. The cornea and lens of a perfectly shaped eye have a smooth circular surface, like a sphere or round ball. With astigmatism, the cornea or the lens will have more of an oblong, football-like shape. Blurred or distorted vision is typically experienced Vision with cataract and astigmatism. Vision with cataract corrected, astigmatism remaining. STAAR Toric corrected vision. by patients with moderate or high degrees of astigmatism. These distortions can be corrected through refractive surgery. The STAAR Toric IOL: The single best option for correcting cataracts and astigmatism. The surgery to remove cataracts is an outpatient procedure, and involves replacing the clouded natural lens with an artificial one. However, if you also have astigmatism you may still experience blurred or distorted vision, since the lens typically implanted during ordinary cataract surgery cannot correct this secondary condition. Astigmatic patients who are planning cataract surgery can request the use of a STAAR Toric IOL during their lens replacement – treating the cataractpatients and thewho astigmatism at the same Astigmatic are planning cataract time. Thecan STAAR Toric ideal for cataract cataract Astigmatic patients who areisplanning surgery request theIOL use of a STAAR Toric patients with regular, pre-existing astigmatism. surgery can request use of a STAAR Toric IOL during their lens the replacement – treating It has beentheir used safely and effectively a IOL during replacement – treating the cataract andlens the astigmatism at theinsame countless number of astigmatism procedures. the cataract and the same time. The STAAR Toric IOL is idealat forthe cataract time. Thewith STAAR Toricpre-existing IOL is idealastigmatism. for cataract patients regular, patients withused regular, pre-existing astigmatism. It has been safely and effectively in a Open your eyes to quality vision today. It has beennumber used safely and effectively in a countless of procedures. countless number procedures. The STAAR Toric IOL of may be the single best solution for providing quality vision to patients with cataracts Open your eyesIt to quality vision today. and astigmatism. is the first such lens to be Open your eyes to quality vision today. approved by the FDA for its effectiveness, safety The STAAR Toric IOL may be the single best solution and reliability. The STAAR Toric IOLvision may be singlewith bestcataracts solution for providing quality to the patients Ifand you have a quality cataract, askfirst your doctor ifto the for providing to patients with cataracts astigmatism. It isvision the such lens be STAAR Toric help you eliminate your and astigmatism. It isalso theits first such lens to safety be approved by IOL the can FDA for effectiveness, astigmatism, allowing youitstoeffectiveness, recapture quality vision approved by the FDA for safety and reliability. – and a hassle-free, spontaneous lifestyle. and reliability. If you have a cataract, ask your doctor if the IfSTAAR you have cataract, askhelp youryou doctor if theyour Torica IOL can also eliminate References Toric IOL STAAR can also you eliminate your astigmatism, allowing youhelp to recapture quality vision 1. National Eye Institute. Prevalence of Adult Vision Impairment and Age-Related Eye Disease astigmatism, allowing recapture quality vision in America Problems in the spontaneous U.S.you 2002;to 22-24 – and a Vision hassle-free, lifestyle. – and a hassle-free, spontaneous lifestyle. References 1. National Eye Institute. Prevalence of Adult Vision Impairment and Age-Related Eye Disease References in America Vision Problems in the U.S. 2002; 22-24 1. National Eye Institute. Prevalence of Adult Vision Impairment and Age-Related Eye Disease in America Vision Problems in the U.S. 2002; 22-24 One simple solution to better vision. One simple solution to better vision. One simple solution to better vision. STAAR® Surgical Company Vision of the future 1911 Walker Ave. Monrovia, CA 91016 (800) 352-7842 www.staar.com ©2013 STAAR Surgical Company 10-0007-51 A ® ® STAAR Surgical Hauptstrasse 104Company Vision of the future CH 2560 Nidau/Switzerland STAAR® Surgical Company 191132 Walker Ave. +41 332 8888 Vision of the future Monrovia, CA 91016 1911 Walker Ave. (800) 352-7842 Monrovia, CA 91016 (800) 352-7842 TheClearChoice. An exceptional balance of stability and predictability: Predictable visual outcomes, stable design, and optical quality in everything you see. Stable. Predictable. Precise. Rotational stability, predictable outcomes, in a balanced astigmatic cataract solution. Single-piece design provides dual-direction positioning. Microetched haptic designed to promote bioadhesion. . S T A B I L I T Y Large foramina promote development of fibrous adhesions to enhance fixation and stability.1 Longer length haptic aids in rotational stability.2 Delivering predictable high quality vision that has patients saying “wow” Available in a range of spherical powers with cylindrical adds of 2.0 D and 3.5 D P R E D I C T A B I L I T Y STAAR Silicone lens technology induces fewer higher order aberrations than acrylic lenses3 I T0 T1 R1 R2 T3 Lower refractive index (RI) when compared to acrylic lenses – minimizing incidence of halos, glare, and ghosting Exceptional Clarity • STAAR Toric IOL demonstrates comparable if not greater visual acuity with stable and predictable outcomes as compared to other competitive toric lenses Exceptional Visual Acuity4 POST-OP UCVA AT 1 MOnTh UCVA CUMULATIVe PeRCenT Of eyeS 97% 91% 81% 72% 57% 62% 26% 19% 20/20 or Better 20/25 or Better AcrySof® Toric IOL (n=47) 20/30 or Better 20/40 or Better STAAR Toric IOL (n=34) Stable and Predictable Outcomes4 PRedICTABILITy Of CyLIndeR CORReCTIOn PeRCenTAge Of eyeS wITh POST-OP MAnIfeST RefRACTIOn CyLIndeR wIThIn 0.5 d And 1.00 d Of TARgeT 98% 100% 86% 86% +/- 0.5 D AcrySof® Toric IOL (n=47) Data courtesy of Dr. Ken Maverick, Dallas, Texas” +/- 1.0 D STAAR Toric IOL (n=29) • STAAR silicone lens technology produces significantly fewer optical aberrations than do acrylic lenses3 Higher Order Aberrations Study3 COMPARISOn Of hIgheR ORdeR ABeRRATIOnS, SILICOne IndUCed feweR ABeRRATIOnS ThAn ACRyLIC 1.28 Pre-Op 0.32 Post-Op 0.31 0.93 Silicone AA4204Vf n=24 Acrylic Alcon SA60 n=16 • STAAR silicone lenses feature a lower refractive index (RI) when I compared to acrylic lenses – minimizing incidence of halos, glare, T0 T1 R1 and ghosting o Light is efficiently transmitted through the silicone lens R2 T3 but commonly reflected through an acrylic lens RI Can Make A Difference In Functional Vision With Night Driving And In The Living Room** Silicone Index of refraction 1.41 no visible glare, halos or ghosting Acrylic Index of refraction 1.55 Serious glare, halos and ghosting *All images depict reflections 10º from line of sight. Rotational Stability Design Improvements Microetched grip • Microetched haptics and large diameter foramina promote bioadhesion • Optimizes capsular bag stability for an exceptional fit Available enhanced horizontal axis IOL (11.2 mm) • greater prevention of lens rotation in nearsighted eyes2 Large foramina • Allow fibrocellular tissue to migrate through and around the lens foramina to secure the lens to the equator of the capsular bag for added stability.1 “fibrous adhesions often occur between the anterior and posterior capsules following ingrowth of fibrocellular tissue through the holes. This helps enhance the fixation and stability of these designs within the capsular bag.”1 david Apple, Md, Charleston, South Carolina Single-piece design • Simplified delivery and controlled placement in dual-directional positioning • highly resistant to rotation compared to C-loop haptic lenses5 • Minimal rate of lens repositioning – and fewer returns to the ophthalmologist2,6,7 Lens Stability That Requires Minimal Repositioning Toric Repositioning Rates2,5,6 STAAR Toric TL 2/130 1.5% AcrySof® Toric 3/263 1.1% “STAAR Toric IOL is my ‘go to’ lens for astigmatism correction. Both in terms of its first-rate clinical performance and my practice’s bottom line, the STAAR Toric IOL takes care of business.” Andrew Siedlecki, Md, Amherst, ny “I have been using the STAAR Toric IOL to treat astigmatism for over a decade and and my experience is that it has excellent rotational stability and the refractive outcomes have allowed an increased freedom from glasses for my patients” Robert J. weinstock, Md, eye Institute of west florida The Clear Choice in Stability and Predictability A 1-2 Combination Knockout Punch in Astigmatic Cataract Surgery. Stable. Predictable. Precise. For more information, please visit www.staar.com or call STAAR Customer Service at 800-352-7842. References Important Safety Information for STAAR Toric IOL 1. Apple dJ, werner L. experts share insights on IOL choice ; The best design is yet to come, Ocular Surgery News. 2002. INDICATIONS: The Silicone 1P Toric IOLs are intended to improve uncorrected visual acuity, correct aphakia and decrease refractive cylinder resulting from corneal astigmatism in persons aged 60 and over. The device is to be implanted into the capsular bag through a tear-free capsulorhexis (circular tear anterior capsulotomy). The 2.0 D Toric IOL is intended for patients having 1.5 D to 2.25 D of pre-existing corneal cylinder while the 3.5 D Toric IOL is intended for patients having greater than 2.25 D of pre-existing corneal cylinder. PRECAUTIONS: 1. The potential for the IOL to rotate causing misalignments that will reduce the effectiveness of the Toric IOL may be greater in larger-than-average eyes. 2. IOL rotation less than 30° may not warrant reorientation. 3. Any reorientations should be performed prior to IOL fixation, generally within the first 2 weeks. 4. Silicone 1P Toric IOL is for Single use. Do not resterilize this intraocular lens by any method as this can produce undesirable side effects. 5. Do not store IOLs at temperatures over 115° Fahrenheit. 6. Use only sterile intraocular irrigating solutions (e.g., balanced salt or normal saline solution) to rinse and/or soak lenses. 7. A high level of Surgical skill is required for intraocular lens implantation. A surgeon should have observed and/or assisted on numerous surgical implantations, and successfully completed one or more courses on intraocular lens implantation before attempting to implant intraocular lenses. 2. Chang df. early Rotational Stability of the Longer Staar Toric Intraocular Lens: fifty Consecutive Cases. J Cataract Refract Surg. 2003;29:935-939. 3. Martin Rg, Sanders dR. A comparison of higher order aberrations following implantation of four foldable intraocular lens designs. J Refract Surg. 2005;21:716-721. 4. data on file, STAAR Surgical. 5. Alio, J. L., et al. (2013) Clinical and optical intraocular performance of rotationally asymmetric multifocal IOL plate-haptic design versus C-loop haptic design; Journal of Refractive Surgery, 29(4); 252-59. 6. david Chang, Md. Comparing the STAAR and AcrySof Toric IOLs. Cataract & Refractive Surgery Today. May 2007. 7. david Chang, Md. Repositioning Technique and Rate for Toric Intraocular Lenses. Journal of Cataract and Refractive Surgery. July 2009. STAAR® Surgical Company Vision of the future 1911 walker Ave. Monrovia, CA 91016 (800) 352-7842 staar.com ©2013 STAAR Surgical Company 10-0007-50 A WARNINGS: 1. This IOL should not be implanted if the posterior capsule is ruptured or if a primary capsulotomy is to be performed. 2. Before implantation of a Toric IOL in the fellow eye, surgeons should verify that the Toric IOL in the first eye is properly aligned. 3. Rotation of toric IOLs away from their intended axis can reduce their effectiveness. Misalignment of greater than 30° - 40° will increase postoperative refractive cylinder. Repositioning of this IOL to the intended axis should only be performed when a significant reduction in effectiveness of the Toric IOL is noticed. This IOL should only be repositioned when the refractive needs of the patient outweigh the potential risks inherent in any surgical reintervention into the eye. 4. YAG-Laser posterior capsulotomies should be delayed until at least 12 weeks after the implant surgery. The posterior capsulotomy opening should be kept as small as possible. There is an increased risk of IOL dislocation and/or secondary surgical reintervention with early or large capsulotomies. 5. As with any surgical procedure, there is risk involved. Potential complications accompanying cataract or implant surgery may include, but are not limited to, the following: corneal endothelial damage, nonpigment precipitates, cystoid macular edema, infection, retinal detachment, vitreous loss, pupillary block, secondary glaucoma, iris prolapse, vitreous wick syndrome, pupillary membrane, corneal endothelial dystrophy, glaucoma, active chronic anterior or posterior uveitis, rubeosis iritis, synechiae, short anterior segment. 6. Some adverse reactions which have been associated with the implantation of intraocular lenses are: hypopyon, intraocular infection and acute corneal decompensation. Secondary surgical interventions include: IOL repositioning, IOL removal due to corneal touch, IOL removal due to inflammation, corneal transplant, IOL replacement, vitreous aspiration for pupillary block, iridectomy for pupillary block. 7. The safety of intraocular lens implantation has not been substantiated in patients with pre-existing ocular conditions (e.g., chronic drug miosis, glaucoma, amblyopia, diabetic retinopathy, previous corneal transplant, history of retinal detachment, or iritis). Physicians considering IOL implantation in such patients should explore the use of alternative methods of aphakic correction and consider IOL implantation only if alternatives are deemed unsatisfactory to meet the needs of the patient. 8. The long-term effects of intraocular lens implantation have not been determined. Therefore, physicians should continue to monitor implant patients postoperatively on a regular basis. 9. Physicians considering IOL implantation in patients with senile macular or retinal degeneration should be aware that the patient may not achieve any improvement in central visual acuity following intraocular lens implantation. 10.Patients with ocular pathology, (e.g., glaucoma or corneal diseases), may not achieve the visual acuity of patients without such problems. 11.Secondary glaucoma has been reported occasionally in patients with controlled glaucoma who received lens implants. The intraocular pressure of implant patients with glaucoma should be carefully monitored postoperatively. 12.The need for a secondary iridectomy for pupillary block may be prevented by one or more iridectomies at the time of IOL implantation. 13.The safety and effectiveness of this IOL if placed in the anterior chamber have not been established. Implantation of posterior chamber lenses in the anterior chamber has been shown in some cases to be unsafe. Such implantation should take place only under an investigational protocol approved by FDA. 14.The effectiveness of UV-absorbing IOLs in reducing the incidence of retinal disorders has not been established. 15.This IOL is not intended, nor should it be used, for a clear lens exchange. 16.Special consideration should be given to the dimensions of IOLs at the extreme ends of the power range in relation to the anatomical clearances in the patient’s eye. The potential impact of factors such as optic central thickness, optic edge thickness, and overall lens size on the patient’s long term clinical outcome must be carefully weighed against the potential benefit associated with the implantation of an intraocular lens. The patient’s clinical progress should be carefully monitored. 17.Since clinical studies was conducted with the IOL being implanted in the capsular bag only, there are insufficient clinical data to demonstrate its safety and efficacy for placement in the ciliary sulcus. 18.Physicians considering IOL implantation under any of the following circumstances should weigh the potential risk/ benefit ratio: a. Recurrent anterior or posterior segment inflammation or uveitis. b. Patients in whom the intraocular lens may affect the ability to observe, diagnose or treat posterior segment diseases. c. Surgical difficulties at the time of cataract extraction which might increase the potential for complications (e.g., persistent bleeding, significant iris damage, uncontrolled positive pressure, or significant vitreous prolapse or loss). d. A distorted eye due to previous trauma or developmental defect in which appropriate support of the IOL is not possible. e. Circumstances that would result in damage to the endothelium during implantation. f. Suspected microbial infection. g. Children under the age of 18 years are not suitable candidates for intraocular lenses. 19.Patients in whom neither the posterior capsule nor zonules are intact enough to provide support. 20.This IOL should not be implanted if the posterior capsule is ruptured or if a primary capsulotomy is to be performed. 21.YAG-Laser posterior capsulotomies should be delayed until at least 12 weeks after the implant surgery. The posterior capsulotomy opening should be kept as small as possible. There is an increased risk of lens dislocation and/or secondary surgical reinterventions with early or large capsulotomies. ATTENTION: Reference the Directions for Use labeling for a complete listing of adverse events which may include iritis and corneal edema. Surgical Guide Stable. Predictable. Precise. power: visit staartoric.com to calculate IOL powers and lens orientation • Spherrical Position Toric IOL to Steep Corneal Meridian 95º 90º Cylinder power selected according to corneal astigmatism nomogram as follows: Position Toric IOL to Steep Corneal Meridian180º 0º 95º 90º With the Rule1 Corneal Astigmatism IOL Cylinder Power Expected Cylinder Correction from IOL2 • Spherrical power: visit staartoric.com to calculate IOL powers and lens orientation 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 3.25 D or more3 3.5 D+ LRIs 2.25 D Against the Rule1 Corneal Astigmatism IOL Cylinder Power Expected Cylinder Correction from IOL2 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 1.25 D to 1.75 D 3.5 D+ 2.0 D LRIs 2.25D D 1.5 2.0 D to 2.5 D 3.5 D 2.25 D 1.25 D to 1.75 D3 2.75 D or more 2.0 D 3.5 D+ LRIs 1.5 D 2.0 D to 2.5 D 3.5 D 2.25 D 180º 0º Cylinder power selected according to corneal astigmatism nomogram as follows: With the Rule1 Corneal Astigmatism 3.25 D or more3 Against the Rule1 IOL Cylinder Power Expected Cylinder Correction from IOL2 Expected Cylinder Correction from IOL • Spherrical power: visit staartoric.com to calculate IOL powers and lens orientation Corneal Astigmatism IOL Cylinder Power 2 2.25 D 3.5 D+ LRIs 2.25 D 2.75 D or more nomogram assumes astigmatically neutral surgery. 1 With the Rule, steep astigmatically corneal meridian between 46 to 134; Against the Rule, steep corneal nomogram assumes neutral surgery. With the Rule, steep corneal meridian between 46 to 134; Against the Rule, steep corneal meridian between 0 to 45 and 135 to 180. meridian between 0 to 45 and 135 to 180. power selected according to corneal astigmatism nomogram as follows: 2Cylinder Approximate Approximate value value ofof the the equivalent equivalent IOL IOL cylinder cylinder power power atat the the cornea. cornea. Combine with Astigmatic keratotomy or Limbal Relaxing Incisions. 3 Combine with Astigmatic keratotomy or Limbal Relaxing Incisions. 3 1 2 3 Available in a range of spherical powers with cylindrical adds of 2.0 D and 3.5 D With the Rule Available in a range of spherical powers with cylindrical adds of 2.0 D and 3.5 D 1 plane, the optics of the 2.0 D and 3.5 D lenses correct • At the corneal 1.4 D and 2.3 D of astigmatism, respectively •Corneal At theAstigmatism corneal plane, the optics of the Power 2.0 D and 3.5 D lenses IOL Cylinder Expectedcorrect Cylinder Correction from IOL2 1.4 D and 2.3 D of astigmatism, respectively 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 3.25 D or more3 3.5 D+ LRIs 2.25 D The STAAR Toric IOL with advanced to: noitatneiro silicone snel dna srewop Llens OI etalucltechnology ac ot moc.cirotraats tisiv :ris ewodesigned p lacirrehpS • • Produce significantly fewer optical aberrations than acrylic lenses1 naidireM laenroC peetS ot LOI ciroT noitisoP • Demonstrates comparable if not better visual acuity with stable and predictable outcomes as º09 º59 compared to the other competitive toric lenses2 :swollof sa marg•oProduce mon mslower itamgincidence itsa laenrofochalos, ot gnglare idrocand ca dglistenings etceles rebecause wop redofnilayClower refractive index of silicone lenses compared to acrylic lenses1 naidireM laenroC peetS ot LOI ciroT noitisoP º0 º081 Prevalence of Astigmatism in the US Population 1 º09 º59 2 eluR eht htiW 30% LOI morf noitcerroC rednilyC detcepxE 31% rewoP rednilyC LOI msitamgitsA laenroC 1.5 D to 3.5 D = 20% 19% noitatneiro snel dna srewop LOI eta luclac ot moc.cirotraats tisiv :rewop lacirrehpS • D 5.1 D 0.2 D 52.2 10% D 5.32% D 52.2 ot D 5.1 D 0.3 ot D 5.2 º0 º081 :swollof sa margomon msitamgitsa laenroc ot gnidrocca detceles rewop rednilyC D 502.2 5% 0.5 1.0 1.5 sIRL2.0+D 5.32.5 1% 1% 3.0 3.5 0% 3 0% erom4.0ro D 4.5 52.3 0% 5.0 SOuRCe: COmPRehenSIve RePORT On The GLObAL IOL mARkeT by mARkeT SCOPe (mAy 2012) 2 LOI morf noitcerroC rednilyC detcepxE 2 LOI morf noitcerroCRotational rednilyC detcepxE D 5.1 D 52.2 rewoP rednilyC LOI 1 eluR eht htiW 1 msitamgitsA laenroC Stability rewoP rednilyC LOI msitamgitsA laenroC D 0.2 D 5.3 eluR eht tsniagA D 52.2 ot D 5.1 D 0.3 ot D 5.2 D 5mm .1 length aids in preventing D 0.2 IOL rotation Dfor57larger .1 ot D 5myopic 2.1 Overall 11.2 eyes D 52.2 sIRL +D 5.3 3 1 2 D 52.2 D 5.3 erom ro D 52.3 eluR eht tsniagA D 5.2 ot D 0.2 noitatneiro snel dna srewop LOI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • LOI morf noitcerroC rednilyC detcepxE rewoP rednilyC LOI msitamgitsA laenroC D D525..21 sIRL +DD 05..23 3D 57.1 ot D 52.1 D 52.2 D 5.3 D 52.2 erom ro D 57.2 D 5.2 ot D 0.2 .ysrIeRgLru+sDla5rt.u3en yllacitamgitsa semeurosm sa rmoaDrgo5m7.o2n laenroc peets ,eluR eht tsniagA ;431 ot 6.y4rengerueswltaerbtuneanidyilrleam egnirtosca pseem etsus,sealuRmaerhgtohmtioWn1 citalam • Promotes greater bioadhesion for capsular bag stability laenroc peets ,eluR eht tsniagA ;431 ot 64 neewteb naidirem laenroc peets ,eluR eht htiW .081 ot 531 dna 54 ot 0 neewteb naidirem :swollof sa margLarge omonforamina msitamg..iaateesnnarroolccaeeehhntt rttaaorrceewwoootpp grreenddinndiillyyr.cco08LLc1OOcIIoatttnn5eed3llaae1vvtiiduucqqneaeele5eehh4sttoffroote0eewuunlleoaaevvpweetttreaaebmmdniixxnaooidrrippliyrppeCAAm2 .snoisicnI gnixaleR labmiL ro ymototarek citamgitsA htiw enibmoC • Large foramina .snoisicnallow I gnixalefibrocellular R labmiL ro ymtissue ototarektocimigrate tamgitsA hthrough tiw enibmoand C3 around the lens hole 3 Microetched haptics 1 2 3 D 5.3 dna D 0.2 fotosdlock da lathe cirdlens nilyctohtthe iw sequator rewop laofcirthe ehpcapsular s fo egnabag r a nfor i eladded baliavAstability 3 “Fibrous adhesions often occur between the anterior and posterior capsules following citpo eht ,enalp lae1nroc eht tA • ivWA D 5.3 dnatcDerr0o.c2 singrowth foessndedl aDla5ofc.3irfibrocellular ddnnilaycDh0ti.w2 setissue rhetwfoopsthrough lacirehpthe s foholes. egnarThis aelunRihelps eelbhtahliatenhance the fixation and ylevitcepser ,msitamgitsa fo D 3.2 dna D 4.1 stability of these designs within the capsular bag.” Dr. David Apple 3 2 l D 5.3 dna Drew0o.2P erehdtnfiolyCsLcOitpI o eht ,enalmpsliataemngriotscAelahetntrAoC• LOI morf noitcerroC rSingle-piece etdcneilyrrCodcestceespnxEedesign ylevitcepser ,msitamgitsa fo D 3.2 dna D 4.1 • Simplified delivery and controlled placement with dual-directional positioning D 5.1 D 0.2 D 52.2 ot D 5.1 • Resists rotation as compared to C-loop lens design4 D 52.2 D 5.3 D 52.2 sIRL +D 5.3 D 0.3 ot D 5.2 3 erom ro D 52.3 •Surgical Spherrical power:Pearls visit staartoric.com to calculate IOL powers and lens orientation Toric IOL to Corneal •Position Patient axis should beSteep marked pre-op Meridian at the slit lamp, and sitting upright • CCC should be no larger than 5.5 mm in diameter 95º 90º Cylinder power selected according to corneal astigmatism nomogram as follows: • minimize bSS infusion of the anterior segment. Leave eye relatively and safely soft to prevent IOL movement. eye somewhat “softer” than usual most likely allows the capsular bag to Position ToricLeaving IOL totheSteep Corneal Meridian 180º 0º collapse around the IOL more immediately 95º 90º Rule viscoelastic. Compared to dispersive viscoelastics, these are less likely to coat •With usethe a cohesive 1 the IOL surface Astigmatism IOLbehind Cylinderthe Power Expected CylindertoCorrection IOL •Corneal Remove viscoelastic trapped IOL with irrigation-aspiration maximizefrom posterior 2 capsule-IOL surface contact • Spherrical power: visit staartoric.com to calculate IOL powers and lens orientation 1.5 D to 2.25 D 2.0 D 2.5 D to 3.0 D 3.5 D 1.5 D • Confirm lens orientation after I&A and after wound closure to ensure that Toric IOL did not move 180º 2.25 D 0º • yAG-Laser posterior capsulotomies should be delayed until at least 12 weeks after the implant Cylinder selected accordingopening to corneal astigmatism nomogram as follows: surgery. power The posterior capsulotomy should be kept as small as possible. There is an 3 3.25 D or more 3.5 D+and/or LRIs secondary surgical 2.25reintervention D increased risk of IOL dislocation with early or large capsulotomies With the Rule1 1 2 Astigmatism should beIOL Cylinder Power Expected Cylinderwithin Correction from2IOL •Corneal Any reorientations performed prior to IOL fixation, generally the first weeks Against the Rule 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 1.25 D to 1.75 D 3.5 D+ 2.0 D LRIs 2.25D D 1.5 2.0 D to 2.5 D 3.5 D 2.25 D 1.25 D to 1.75 D3 2.75 D or more 2.0 D 3.5 D+ LRIs 1.5 D 2.0 D to 2.5 D 3.5 D 2.25 D Corneal Astigmatism 3.25 D or more3 Against the Rule1 IOL Cylinder Power Expected Cylinder Correction from IOL2 Expected Cylinder Correction from IOL • Spherrical power: visit staartoric.com to calculate IOL powers and lens orientation Corneal Astigmatism IOL Cylinder Power 2 2.25 D 3.5 D+ LRIs 2.25 D 2.75 D or more nomogram assumes astigmatically neutral surgery. 1 With the Rule, steep astigmatically corneal meridian between 46 to 134; Against the Rule, steep corneal nomogram assumes neutral surgery. With the Rule, steep corneal meridian between 46 to 134; Against the Rule, steep corneal meridian between 0 to 45 and 135 to 180. meridian between 0 to 45 and 135 to 180. power selected according to corneal astigmatism nomogram as follows: 2Cylinder Approximate Approximate value value ofof the the equivalent equivalent IOL IOL cylinder cylinder power power atat the the cornea. cornea. Combine with Astigmatic keratotomy or Limbal Relaxing Incisions. 3 Combine with Astigmatic keratotomy or Limbal Relaxing Incisions. 3 1 2 3 Available in a range of spherical powers with cylindrical adds of 2.0 D and 3.5 D With the Rule Available in a range of spherical powers with cylindrical adds of 2.0 D and 3.5 D 1 plane, the optics of the 2.0 D and 3.5 D lenses correct • At the corneal 1.4 D and 2.3 D of astigmatism, respectively •Corneal At theAstigmatism corneal plane, the optics of the Power 2.0 D and 3.5 D lenses IOL Cylinder Expectedcorrect Cylinder Correction from IOL2 1.4 D and 2.3 D of astigmatism, respectively 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 3.25 D or more3 3.5 D+ LRIs 2.25 D STAAR noitatneToric iro snel dna IOL srewop LCalculator OI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • aidireM laenroC peetS ot LOI ciroT noitisoP PreVize Optimized Toric IOL calculationnsoftware º09 º59 :swollof sa margomon msitamgitsa laenroc ot gnidrocca detceles rewop rednilyC naidireM laenroC peetS ot LOI ciroT noitisoP º0 º081 º09 º59 2 LOI morf noitcerroC rednilyC detcepxE eluR eht htiW 1 rewoP rednilyC LOI msitamgitsA laenroC noitatneiro snel dna srewop LOI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • D 5.1 D 0.2 D 52.2 ot D 5.1 D 52.2 D 5.3 D 0.3 ot D 5.2 D 52.2 sIRL +D 5.3 º0 º081 :swollof sa margomon msitamgitsa laenroc ot gnidrocca detceles rewop rednilyC •2LCreates OI morf na oitsurgical cerroC redworksheet nilyC detcepthat xE includes preoperative rewoP rednilyCdata LOI 3 erom ro D 52.3 1 eluR eht htiW 1 msitamgitsA laenroC eluR eht tsniagA D 5.1 D 0.2 •2 List of suggested surgical powers (The choice of the lens selection is yours) D 52.2 ot D 5.1 LOI morf noitcerroC rednilyC detcepxE D 52.2 rewoP rednilyC LOI D 5.3 msitamgitsA laenroC • Clearly labeled illustration of the exact placement of the STAAR Toric IOL D 5.1 D 52.2 D 0.2 sIRL +D 5.3 D 0.3 ot D 5.2 Der5o7m.1root DD 5522..31 3 • To ensure that the power of the cylindrical correction is maximized, use the two markings indicat1 eluR eht tsniagA ing the axis of the cylindrical correction of the lens and align them with the steep corneal meridian 2 D 52.2 D 5.3 D 5.2 ot D 0.2 noitatneiro snel dna srewop LOI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • LOI morf noitcerroC rednilyC detcepxE D D525..21 D 52.2 rewoP rednilyC LOI msitamgitsA laenroC 3D 57.1 otrequired sIRSTAAR L +DD 05..23 Toric IOL calculator erom ro DD 5572..21 data D 5.3 D 5.2 ot D 0.2 • Steep k reading D 52.2 .ysrIeRgLru+sDla5rt.u3en yllacitamgitsa semeurosm sa rmoaDrgo5m7.o2n • Steep k meridian/axis laenroc peets ,eluR eht tsniagA ;431 ot 6.y4rengerueswltaerbtuneanidyilrleam egnirtosca pseem etsus,sealuRmaerhgtohmtioWn1 citalam laenroc peets ,eluR eht tsniagA ;431 ot 64 n•eeFlat wtebk ..008811nooareading ttid55ir33e11mddlnnaaaen55r44ocoottpe00enntseeee,ewwlutteeRbbennhaatiiddhiitrrieeWm :swollof sa margomon msitamg..iaateesnnarroolccaeeehhntt rttaaorrceewwoootpp grreenddinndiillyyrccoLLcOOcIIattnneedllaaevvtiiuucqqeeeleeehhstt ffrooeeewuulloaavvpeettraaemmdiixxnoorripplyppCAAm2 • Flat k meridian/axis .snoisicnI gnixaleR labmiL ro ymototarek citamgitsA htiw enibmoC .snoisicnI gnixaleR labmiL ro ymototarek citamgitsA htiw enibmoC3 3 1 2 3 • Surgically induced astigmatism D 5.3 dna D 0.2 fo sdda lacirdnilyc htiw srewop lacirehps fo egnar a ni elbaliavA (SIA) estimate tcerroc sesnel D 5.3 dna D 0.2 eht fo scitpo eht ,enalp lae1nroc eht tA • ylevitceps•erIncision ,msitamsite gitsa fo D 3.2 dna D 4.1 D 5.3 dna D 0.2 fo sdda lacirdnilyc htiw srewop lacirehps fo egnar aelunRi eelbhtahliativWA 2 fiolyCsLcOitpI o eht ,enalmpsliataemngriotscAelahetntrAoC• LOI morf noitcerroC retdcneilyrrCodcestceespnxEel D 5.3 dna Drew0o.2P erehdtnwww.staartoric.com ylevitcepser ,msitamgitsa fo D 3.2 dna D 4.1 D 5.1 D 0.2 D 52.2 ot D 5.1 D 52.2 D 5.3 D 52.2 sIRL +D 5.3 D 0.3 ot D 5.2 3 erom ro D 52.3 • Spherrical power: visit staartoric.com to calculate IOL powers and lens orientation Position PositionToric ToricIOL IOLtotoSteep SteepCorneal CornealMeridian Meridian 95º 95º 90º 90º Cylinder power selected according to corneal astigmatism nomogram as follows: Position Toric IOL to Steep Corneal Meridian 180º 180º 0º0º 95º 90º With the Rule1 Corneal Astigmatism IOL Cylinder Power Expected Cylinder Correction from IOL2 • •Spherrical Spherricalpower: power:visit visitstaartoric.com staartoric.comtotocalculate calculateIOL IOLpowers powersand andlens lensorientation orientation 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 3.25 D or more3 3.5 D+ LRIs 2.25 D 180ºastigmatismnomogram 0º Cylinder Cylinderpower powerselected selectedaccording accordingtotocorneal cornealastigmatism nomogramas asfollows: follows: 1 1 With Withthe theRule Rule Against the Rule 1 Corneal CornealAstigmatism Astigmatism IOL IOLCylinder CylinderPower Power 2 2 Expected ExpectedCylinder CylinderCorrection Correctionfrom fromIOL IOL 1.51.5DDtoto2.25 2.25DD 2.0 2.0DD 1.51.5DD 2.5 2.5DDtoto3.0 3.0DD 3.5 3.5DD 2.25 2.25DD 2.0 D 2.25 2.25DD Corneal Astigmatism 1.25 D to 1.75 D 3 3 3.25 3.25DDorormore more Against Againstthe theRule Rule IOL Cylinder Power 3.5 3.5D+D+LRIs LRIs Expected Cylinder Correction from IOL2 1.5 D 1 1 2.0 D to 2.5 D 3.5 D 2.25 D • Spherrical power: visit staartoric.com to calculate IOL powers and lens orientation Corneal CornealAstigmatism Astigmatism 2.75 D or more IOL IOLCylinder CylinderPower Power 3.5 D+ LRIs 2 2 Expected ExpectedCylinder CylinderCorrection Correctionfrom fromIOL IOL 2.25 D 1.25 1.25DDtoto1.75 1.75DD3 2.0 2.0DD 1.51.5DD 2.0 2.0DDtoto2.5 2.5DD 3.5 3.5DD 2.25 2.25DD 3.5 3.5D+D+LRIs LRIs 2.25 2.25DD nomogram assumes astigmatically neutral surgery. 1 With the Rule, steepastigmatically corneal meridian between 46 to 134; Against the Rule, steep corneal nomogram nomogram assumes assumes astigmatically neutral neutral surgery. surgery. With Withthe theRule, Rule,steep steepcorneal cornealmeridian meridianbetween between4646toto134; 134;Against Againstthe theRule, Rule,steep steepcorneal corneal meridian between between0 00toto to4545 45and and 135 135toto to180. 180. meridian meridianbetween and135 180. power selected according to corneal astigmatism nomogram as follows: 2Cylinder Approximate Approximate value equivalent cylinder power cornea. Approximatevalue valueofofofthethe theequivalent equivalentIOLIOL IOLcylinder cylinderpower poweratatatthethe thecornea. cornea. Combine Combinewith withAstigmatic Astigmatickeratotomy keratotomyororLimbal LimbalRelaxing RelaxingIncisions. Incisions. 3 Combine with Astigmatic keratotomy or Limbal Relaxing Incisions. 2.75 2.75DDorormore more 3 3 1 1 2 2 3 3 Available Availableinina arange rangeofofspherical sphericalpowers powerswith withcylindrical cylindricaladds addsofof2.0 2.0DDand and3.5 3.5DD With the Rule Available in a range of spherical powers with cylindrical adds of 2.0 D and 3.5 D 1 plane, • •AtAtthe thecorneal corneal plane,the theoptics opticsofofthe the2.0 2.0DDand and3.5 3.5DDlenses lensescorrect correct 1.4 1.4DDand and2.3 2.3DDofofastigmatism, astigmatism,respectively respectively •Corneal At theAstigmatism corneal plane, the optics of the Power 2.0 D and 3.5 D lenses IOL Cylinder Expectedcorrect Cylinder Correction from IOL2 1.4 D and 2.3 D of astigmatism, respectively 1.5 D to 2.25 D 2.0 D 1.5 D 2.5 D to 3.0 D 3.5 D 2.25 D 3.25 D or more3 3.5 D+ LRIs 2.25 D Stable. Predictable. Precise. 10.8 AA4203TF noitatneiro snel dna srewop LOI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • Optic Characteristics Diopter Powers Cylinder naidireM laenroC 24 peDetotS28.5 otDLO I cDiIncrements) roT noitisoP (0.5 2.0 D and 3.5 D º09 º59 Shape 6.0mm Biconvex Material Silicone Refractive index 1.41 :swollof sa margomon msitamgBiometry itsa laenroc ot gnidrocca detceles rewop rednilyC º081 ACD º09 º59 2 naidireM laenroC 118.5 pee(Suggested) tS ot LOI ciroT noitisoP A-Constant º0 LOI morf noitcerroC rednilyC detcepxE 5.26 Haptic Characteristics eluR eht htiW 1 Overall length 10.8 mm Material Silicone 1.15 Diameter rewoP rednilyC LOOne-Piece I msitamgForamina itsA laenroC Design Style Single Piece noitatneiro snel dna srewop LOI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • D 5.1 11.2 D 52.2 AA4203TL D 0.2 D 52.2 ot D 5.1 D 5.3 D 0.3 ot D 5.2 º0 º081 :swollof sa margomon msitamgitsa laenroc ot gnidrocca detceles rewop rednilyC Optic Characteristics D 52.2 sIRL +D 5.3Diopter Powers Shape 2 2 LOI morf noitcerroC rednilyC detcepxE Material Silicone rewoP rednilyC LOI Refractive index D 5.1 Biometry 2 D 52.2 1.41 D 0.2 rewoP rednilyC LOI D 52.2 A-Constant D 5.1 erom ro D 52.3 Cylinder D 52.2 ot D 5.1 msitamgitsA laenroC D 0.3 ot D 5.2 5.26 D 0.2 Der5o7m.1root DD 5522..31 sIRL +D 5.3 Haptic Characteristics Overall length Material eluR eht tsniagA 1 msitamgitsA laenroC D 5.3118.5 (Suggested) ACD 11.2 mm D 5.3Silicone 2 D and 3.5 D eluR eht htiW 1 6.0mm Biconvex LOI morf noitcerroC rednilyC detcepxE D 52.2 3 9.5 D to 23.5 D (0.5 D Increments) 3 1 eluR eht tsniagA D 5.2 ot D 0.2 noitatneiro snel dna srewop LOI etaluclac ot moc.cirotraats tisiv :rewop lacirrehpS • LOI morf noitcerroC rednilyC detcepxE D D525..21 Design rewoP rednilyC LOI sIRL +DD 05..23Single Piece Style D 52.2 References msitamgitsA laenroC One-Piece 1.15 Diameter Foramina erom ro D 57.2 3D 57.1 ot D 52.1 D 5.3 D 52.2 D 5.2 ot D 0.2 .ysrIeRgLru+sDla5rt.u3en yllacitamgitsa semeurosm sa rmoaDrgo5m7.o2n laenroc peets ,eluRFor eht tsniamore gA ;431 otinformation, 64 neewteb naidirem laenplease roc peets ,eluvisit R eht htiWwww.staar.com or call STAAR Customer 800-352-7842. ..008811 oott 553311 ddnnaa 5544 ooService tt 00 nneeeewwtteebb nnaaiiddat iirreem m 2. Data on File, STAAR Surgical. : s w o l l o f s a m a r g o m o n m s i t a m g i t s a l a e n r o c o t g n i d r o c c a d e t c e l e s r e w o p r e d n i l y C 2 ..a 3. Apple DJ, Werner L. experts share insights aeennrroocc eehhtt ttaa rreewwoopp rreeddnniillyycc LLOOII ttnneellaavviiuuqqee eehhtt ffoo eeuullaavv eettaam miixxoorrppppAA on IOL choice ; The best design is yet to .snoisicnI gnixaleR labmiL ro ywww.staar.com mototarek citamgitsA htiw enibmoC come, Ocular Surgery News. 2002. .snoisicnI gnixaleR labmiL ro ymototarek citamgitsA htiw enibmoC3 3 1. martin RG, Sanders DR. A comparison of higher order aberrations following implanta1 .yregrus lartuen yllacitamgitsa semussa margomon tion of four foldable intraocular lens designs. laenroc peets ,eluR eht tsniagA ;431 ot 64 neewteb naidirem laenroc peets ,eluR eht htiW1 J Refract Surg. 2005;21:716-721. 2 3 4. Alio, J. L., et al. (2013) Clinical and optical 5.3 dna D 0.2 fo sdda lacirdnilyc htiw intraocular performance ofD rotationally asymmetric multifocal IOL plate-haptic design versus C-loop haptic design; Journal tcerroc sesnel D 5.3 dna D 0.2 of Refractive Surgery. 29(4); 252-59. srewop lacirehps fo egnar a ni elbaliavA D 5.3 dna D 0.2 fo sdda lacirdnilyc htiw serhetwfoopsclaitcpioreehhpts,efonaelgpnlaare1anelrunoRiceeelbhhtathlitatAivWA• ylevitcepser ,msitamgitsa fo D 3.2 dna D 4.1 Previze® is a registered trademark of Previze. LOI morf noitcerroC retdcneilyrrCodcestceespnxEel D 5.3 dna Drew0o.2P erehdtnfiolyCsLcOitpI o eht ,enalmpsliataemngriotscAelahetntrAoC• ylevitcepser ,msitamgitsa fo D 3.2 dna D 4.1 D 5.1 D 0.2 D 52.2 ot D 5.1 ©2013 STAAR 2 Surgical Company 10-0007-52 A Latvijas LatvijasAmerikas Amerikasacu acucentrs centrs••A.A.Deglava Deglavaiela iela12A, 12A,Rīga, Rīga,LV-1009, LV-1009,Latvija Latvija D 52.2 D 5.3 D 0.3 ot D 5.2 D 52.2 sIRL +D 5.3 erom ro D 52.3 Tirdzniecības Tirdzniecībasun uniepirkuma iepirkumadirektors, direktors,Rolands RolandsLārmanis Lārmanis T:T:(+371) (+371)67272257 67272257••GSM: GSM:(+371) (+371)29210121 29210121••Fakss: Fakss:(+371) (+371)67272128 67272128 E-pasts: E-pasts:[email protected] [email protected]••www.laac.lv www.laac.lv 3