Vis Tor The new Toric IOL by Hanita

Vis. Tor The new Toric IOL by Hanita Lenses Sept 2013

Definition Astigmatism - The cornea has different radii (Dpt) in different meridians, causing the focus to spread between two points.

Effect on vision The image may be clearly focused on the retina in the horizontal plane, but not in the vertical plane: Or vice-versa: Or at any other angle…

Diagnosis: Regular astigmatism IOLMaster Topographer

Diagnosis: Irregular Astigmatism IOLMaster Topographer

Correction of astigmatism by IOL Astigmatic cornea can be represented as cylinder, causing vertical rays focus differently from horizontal ones, leading to dispersion of focus and blurry image quality. This can be corrected by placing additional cylinder of the same power, rotated by 900. This is the principle of action of the toric IOL. The IOL corrects the dispersion induced by the cornea, focusing the rays in one point on the retina and restoring the sharp image quality.

Correction of astigmatism by IOL Astigmatic cornea can be represented as cylinder, causing vertical rays focus differently from horizontal ones, leading to dispersion of focus and blurry image quality. This can be corrected by placing additional cylinder of the same power, rotated by 900. This is the principle of action of the toric IOL. The IOL corrects the dispersion induced by the cornea, focusing the rays in one point on the retina and restoring the sharp image quality.

Vis. Tor Platform Excellent stability in the capsular bag endurance to rotation, tilt & decentration. Visible axis marking even for small pupils Injection through 1. 8 mm incision 3600 enhanced square edge decrease PCO

Aspheric optics Anterior toric surface, posterior aspheric surface Designed using Arizona Uni. model, with statistical eye data of old population Standard corneal spherical aberration +0. 27µ, corrected by natural lens IOL asphericity -0. 14, leaving residual +0. 13µ for better contrast sensitivity, shown in Prof. Tetz study Total correction of Toric aberrations

Raw material Hydrophilic acrylic 25% water, produced by Benz R&D (USA) >10 years clinical experience and > 1 million implantations of Hanita’s IOLs Violet light blocker equivalent to natural chromophore. Better transmission of blue light than yellow IOLs – important for dim light situations High Abbe number, low Refractive index (1. 46 @35 o) means less chromatic aberrations & higher contrast sensitivity

Toric Calculator order form, on www. hanitalenses. com

Toric Calculator, on www. hanitalenses. com

Clinical Study + Post marketing evaluation Participating centers Total no of eyes (planned) 9 Germany, France, Israel, Colombia, Czech republic 180 Follow-up visits Pre-op, surgery, 1 & 3 months Implanted eyes 45 Eyes with follow-up >1 M 14

Clinical Study preliminary results (Sept 2013) Results Preliminary study for : rotational stability & Refraction accuracy

Clinical Study preliminary results (Sept 2013) Refractive cylinder (n=14) Cylinder Pre-Op vs. Post-Op 3. 50 3. 00 2. 50 2. 00 1. 50 1. 00 0. 50 0. 00 Pre. Op Post. Op 70% of patients obtained Cylinder under 0. 5 D post op

Clinical Study preliminary results (Sept 2013) Spherical equivalent refraction Post-Op (1 -3 Months) 80% 70% 60% 50% 40% 30% 20% 10% < +1. 5 +1 to +0. 5 +0 to 5 -0. +1 . 5 5 -0. to -1 . 5 -1 0% ≤ Percentage of patients (n=14) 90% Spherical Equivalent Refraction - Targeted refraction (Diopters)

Clinical Study preliminary results (Sept 2013) Visual Acuity Post-Op (1 -3 Months) 90% 80% UCVA 70% BCVA 60% 50% 40% 30% 20% 10% 0. 4 Visual Acuity (Decimal) *Patient with refraction of: Sph=0, Cyl=0 to 2 0. 4 to 0. 6 8 0. to 6 0. 8 to 1 ≤ 0% 2 * 1 Percentage of patients (n=14) 100%

Clinical Study preliminary results (Sept 2013) Rotational Stability (1 -3 Months) Percentage of patients (n=14) 70% 60% 50% 40% 30% 20% 10% 9< 9 to 7 5 to 3 ≤ 3 0% Deviation from implanted position (Degrees) * Significant rotation (>15º) has occurred in 2 eyes with high AL (>26 mm). Both cases are not included above due to short follow-up time (<1 M). Due to this, for improved stability in long eyes, IOLs below 16 dpt are provided with external diameter of 11. 5 mm

Preliminary conclusions (Sept 2013) - The Hanita Vis. Tor is a MICS lens with toric optics - It can be implanted through 1. 8 mm incisions, with no impairment of existing corneal astigmatism - It can be easily positioned, by clockwise and counterclockwise rotation - For improved stability in long eyes, IOLs below 16 dpt are provided with external diameter of 11. 5 mm - Precise refraction and correction of astigmatism

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