Johnson & Johnson Vision announced the availability of two new developments in the treatment of cataracts for patients with astigmatism in Europe. Tecnis Synergy Toric II IOL with Tecnis Simplicity Delivery System is a continuous-range-of-vision lens engineered for rotational stability, which locks in visual performance and provides high-quality vision day and night.^1,3 Catalys System cOS 6.0, the new software for the Catalys Precision Laser System, offers new features for astigmatism management workflow that can speed up surgical processes and improve accuracy.^2,4,5

The announcements coincide with the 38^th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), held virtually October 2-4.

“The Tecnis Synergy Toric II IOL means we can now give cataract patients with astigmatism our most advanced IOL solution yet, whilst the Catalys System cOS 6.0 is a software package that allows for better accuracy, speed and ease of use for the surgeon for a whole range of astigmatism procedures,” Erin McEachren, Regional Vice President, Europe, Middle East & Africa, Johnson & Johnson Surgical Vision, said in a company news release. “This is the best of both worlds for people with cataracts and astigmatism – our best Toric II IOL in a preloaded delivery system with the most advanced software tool for ease, speed and accuracy in aligning the lens.”

The Tecnis Synergy Toric II is a newly designed innovative lens with a nearly flat defocus curve and a squared and frosted haptic design, which provides resistance to rotation common in astigmatism.^1,12 The new lens outperforms existing PC-IOLs on the market due to its key features, which include:

• A broad range of continuous vision¹²
• Continuity without the visual gaps present in trifocal technology, covering 33 cm to distance³
• Superior low-light performance for reading in dim lighting³

The new Catalys System cOS 6.0 software with advanced astigmatism management is a collaboration with Cassini Technologies B.V. The new software simplifies astigmatism management workflow and increases operational efficiency by:

• Minimizing data entry verification and manual transcription errors through direct input of preoperative keratometry and steep axis values data⁴
• Reducing time spent on calculations, by including calculation of accurate incision parameters using built-in nomogram and automatic input of accurate incision parameters into the treatment planning screen⁴
• Reduces need for intraoperative aberrometry for Toric IOL alignment with radial laser marks placed within a mean accuracy of 6° provide 5.5X greater precision compared to manual marking of the cornea with an ink pen (mean accuracy 3.3°)⁵
• Addition of iris registration for automatic cyclorotation compensation, through collaboration with Cassini Technologies⁴

“The introduction of the Catalys System cOS 6.0 along with the Tecnis Synergy Toric II IOL means that ophthalmologists and patients now have an increased range of solutions for correcting astigmatism,” Professor Dr Burkhard Dick, Chairman of The University Eye Hospital Bochum in Bochum, Germany, said in the news release. “Toric IOLs are an excellent option for correcting astigmatism in cataract patients. Now these patients can have the most advanced premium IOL on the market – allowing for high-quality, continuous vision, even in low-light conditions, in the new and improved Tecnis Synerg Toric II IOL. In addition, the Catalys System cOS 6.0 means that ophthalmologists now have highly advanced software to assist with speed and accuracy across a range of astigmatism procedures.”

Tecnis Synergy Toric II IOL has CE Mark approval and is now commercially available across Europe.

The Catalys System cOS 6.0 will be commercially available in EMEA beginning in the fourth quarter of 2020.

References:

1. DOF2019OTH4015 – Study NXGT-103-MER3 – Proof of Concept Study for Next Generation IOL Models MER003 and
2. Koch DD, et al. Assessment of the Accuracy of an Iris Registration Algorithm of a Femtosecond Lase for Measuring Cyclotorsion in Eyes with Cataract Surgery. Abstract #65609. May 16, 2020. ASCRS Virtual Annual Meeting. R
3. DOF2019OTH4002 – Weeber MTF of the TECNIS Synergy OptiBlue IOL, and other lens models. 27 Mar 2019.
4. CATALYS Operator Manual 0160-6413 0 – OUS. Rev. C, Oct. 2019. REF2020CT4208. Details for 0160-6413 Ops Manual, OUS EN:
   • Direct Input of preoperative keratometry and steep axis values data: Section ‘Plan a Treatment’, 105, Figure 3.61
   • Plan a Treatment (Pre-Op) Screen Import of patient steep meridian orientation with iris registration: Import: ‘Import Patient Data’, Figure 67 Plan a Treatment (Pre-Op) screen – CASSINI Import (p. 108).
   • Iris Registration with steep meridian orientation: ‘CASSINI Iris Registration’, 155. Figure3. 114 Surface Mapping Review Screen for CASSINI Import with Iris View Button Selected.
   • Surface Mapping Review Screen for CASSINI Import with Iris Registration Cyclorotation Selected Automatic cyclorotation compensation: Iris Registration with steep meridian orientation: ‘CASSINI Iris Registration’, 156. Figure 3.115.
   • Onboard nomogram for calculation of arcuate incisions: Arcuate Incision Calculator 116- 120, Figures 3.73-3.79. Radial intrastromal laser marks for toric IOL alignment: Arcuates / Torics (Basic) Screen – Toric Marks – Fig. 3.82. p. 123, Arcuates / Torics (Details) Screen – Toric Marks Fig. 3.83, p. 124, Toric Mark Parameters Fig. 4.6, p. 187.
5. Scott W, et al. Accuracy of Intra-Stromal Corneal Toric IOL Alignment Marks in PMMA Spheres with a Femtosecond Laser Abstract #66563. May 16, 2020. ASCRS Virtual Annual Meeting. REF2020CT4087.
6. World Health Organization – Priority Eye REF2016OTH0004.
7. Wolffsohn JS, et al. Effect of uncorrected astigmatism on J Cataract Refract Surg 2011;37(3): 454-460. REF2018OTH5219.
8. Read SA, et al. The visual and functional impacts of astigmatism and its clinical Ophthalmic Physiol Opt 2014;34(3):267-294. REF2020OTH4615.
9. Williams KM, et Prevalence of refractive error in Europe: the European Eye Epidemiology (E(3)) Consortium. Eur J Epidemiol. 2015;30(4):305-315. doi:10.1007/s10654-015-0010-0. REF2020OTH4618.
10. Nunez MX, et al. Consensus on the management of astigmatism in cataract surgery. Clin Ophthalmol 2019;13:311-324. REF2019OTH4555.
11. Ma JJ, Tseng Simple method for accurate alignment in toric phakic and aphakic intraocular lens implantation. J Cataract Refract Surg 2008;34(10):1631-1636. REF2014CT0231.
12. TECNIS Synergy Toric II IOL – DfU – OUS – Z311414, Rev. A, May 2020. REF2020CT4215.
13. University of Michigan Kellogg Eye Center http://www.kellogg.umich.edu/patientcare/conditions/cataract.html. Accessed September 2020. REF2016OTH0327.
14. Trikha S, et The Journey to Femtosecond Laser-Assisted Cataract Surgery: New Beginnings or False Dawn? Eye 2013;27:461-473. REF2015OTH0014.
15. Eurostat – Surgical operations and procedures https://ec.europa.eu/eurostat/statistics- explained/index.php/Surgical_operations_and_procedures_statistics#In-patient_procedures: _cataract_surgery. Accessed September 2020. REF2018CT4377.
16. American Optometric Presbyopia. American Optometric Association (AOA) Web site. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/presbyopia. Accessed September 2020. REF2019CT4316.