MediconturMedical Engineering [email protected]
Head OfficeHerceghalmi Road 1.2072 ZsámbékHungary
International OfficeChemin des Aulx 181228 Plan-les-OuatesGeneva/Switzerland
LESS STEPS – MORE VISION
”Exceptionally good platform and an optic that generates more patient satisfaction in terms of defocus curves and perceived dysphotopsia symptoms. I would not change a thing about this IOL.“
J. Fernandez MD, PhD, Spain WOC 2018, Barcelona
FOCUSon the patients visionsince 1989
Medicontur stands for consistent high quality, proven by more than
6 millionintraocular lensesimplanted.
„Clinical evidence of prospective randomized study catapulted Liberty into the high quality trifocal group of IOLs available on the market.“
E. Van Acker, MD, Belgium ESCRS 2017, Lisabon
TRIFOCAL Complete Spectacle Independence
7 RINGS TO PERFECTIONSuperior Contrast Sensitivity
THE MOST BALANCED TRIFOCAL IOL
liberty-lens.com
References A. AF, Dunai et al. (Hungary) Comparison of two multifocal IOL Types (50 Bi-Flex M &50 Acrysof IQ) – long term visual outcome. ESCRS 2016, 2017. B. E. Van Acker, MD, (Belgium) Comparison of clinical outcomes and patient satisfaction after implantation of two different types of diffractive apodized IOLs: 40 Bi-Flex M (based on PAD technology) 40 Finevision (Micro F) trifocal diffractive IOL. Prospective, randomized, observational study. ESCRS 2017. C. J. Györy (Hungary) Long term funcional and morphological outcomes and patient satisfaction after cataract surgery with 100 BiFlex M implantation with/without posterior central circular capsulorhexis (PCCC). ESCRS 2016, 2017. D. J. Fernandez MD, PhD, (Spain) Visual performance of patients implanted with progressive PAD Bi-Flex M analyzed by the Qvision iPAD Multifocal LensAnalyzer. ESCRS 2017. E. E. Law et al. (UK) Randomised clinical trial of the Bi-Flex M multifocal intraocular lens. ESCRS 2017. F. A Dexl. (Austria) Visual Outcome, Patient Satisfaction and Spectacle Independency after Implantation of 50 eyes ith Progressive Bi-Flex M. Final Result of a Multicentric Trial with 50 Conscecutive Patients. ESCRS 2015. G. C. Naval. (Philippines) Evolution of multifocal practice. ESCRS 2014. H. N. Meijide (Argentina) Visual Outcomes After Bilateral Implantation of a New Progressive Apodized Diffractive Trifocal IOL. Clinical outcome ASCRS 2018 ID 42517. I. J. García-Bella et al. (Spain) Visual outcomes after progressive apodized diffractive intraocular lens implantation. Eur J Ophthalmol. 2017 Sep. J. M. Assouline MD, PhD, (France) Comparative Outcome of Four Multifocal Intraocular Lens. ESCRS 2015.
ENHANCED QUALITY OF VISION
IOL manufacturers eagerly compete for superior intermediate performance or compress the addition towards the intermediate to create some „comfort“. While doing this they disregard the main key of success for multifocal IOLs – SPECTACLE INDEPENDENCE.
Medicontur chooses not to compromise IOL performance.
Liberty equates to spectacle independence without the compromise of reduced image quality or visual acuity at near and far distances.
LIBERTY FOR YOUR PATIENTS
2
THE MOST BALANCED TRIFOCAL IOL
Less Diffractive Steps – More Vision
Light is scattered within an IOL by every diffractive step. Considerable additional light scattering is caused by the manufactured imperfections of these steps on multiple points.
Therefore not only the quality but also the quantity of the manufactured steps has a great impact on light scattering and loss of light energy.
The below symbolic figures demonstrate the difference in light scattering and energy loss on two separate diffractive IOL profiles.
Quantity of Scattered Light
What does LESS STEPS mean for your patients?Less light scattering improves vision by Higher Contrast Sensitivity Less Halos & Glare
N I F
N I F
Figure 1a:LIBERTY optic with 7 diffractive steps Moderate light scattering
Figure 1b:Diffractive optic with2× more diffractive steps creates minimum3× more light scattering
Out-Of-Focus Light IntensityDistribution by Visualization ofLight Propagation along the Optical Axis
Which Lens Would You Prefer For Driving At Night?* Simulated by Zemax extension for calculation of light propagation after custom defined diffractive surfaces.
Light Energy Intensity at 4.5 mm Aperture* Halos in FAR focal plane
Log of relative intensity (-)
Log of relative intensity (-)
Log of relative intensity (-)
Defocus (D) Distance from optical axis (μm)
Distance from optical axis (μm)
Distance from optical axis (μm)
5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 +0.5 -1.0
Dist
ance
from
opt
ical
axi
s (μm
)
150
100
50
0
-50
-100
-150
80
60
40
20
0
0-20 20-40 40-60 60-80 80
0-20 20-40 40-60 60-80 80
0-20 20-40 40-60 60-80 80
-20
-40
-60
-80
80
60
40
20
0
-20
-40
-60
-80
80
60
40
20
0
-20
-40
-60
-80
0
-1
-2
-3
-4
-5
-6
-7
-8
0
-1
-2
-3
-4
-5
-6
-7
-8
0
-1
-2
-3
-4
-5
-6
-7
-8
0
-1
-2
-3
-4
-5
-6
-7
-8
0
-1
-2
-3
-4
-5
-6
-7
-8
0
-1
-2
-3
-4
-5
-6
-7
-8
Medicontur Liberty
OUT-OF-FOCUS INTENSITY
OUT-OF-FOCUS INTENSITY
OUT-OF-FOCUS INTENSITY
NEAR
NEAR
NEAR
FAR
FAR
FAR
Defocus (D)5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 +0.5 -1.0
Dist
ance
from
opt
ical
axi
s (μm
)
150
100
50
0
-50
-100
-150
Competitor 1 - quadrifocal
Defocus (D)5.0 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 +0.5 -1.0
Dist
ance
from
opt
ical
axi
s (μm
)
150
100
50
0
-50
-100
-150
Competitor 2 – trifocal apodized
4
Figure 2: MTF through focus curves with central diffractive phase shifts at a destructive and a constructive interference level resulting in a 3rd focal point for intermediate vision.
Figure 1: Radial profile with central diffractive phase shift elevated from a destructive level to a constructive interference level.
λP
hase
Shi
ft (
)
Radial distance from the optical axis (mm)
Bifocal = Destructive interference phase levelTrifocal = Elevated Phase Shift* Constructive interference
* patent pending
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.00.0 0.4 0.6 0.8 1.0 1.2 1.40.2
-0.8 -0.5 -0.3 0.0 0.3 0.5 0.8 1.0 1.5 1.5 1.8 2.0 2.3 2.5 2.8 3.0 3.3 3.5 3.8 4.0
MTF
@ 5
0 lp
/mm
Defocus in ISO eye model (D)
Bifocal = Destructive interference levelTrifocal = EPS * Constructive interference
* patent pending
0.40
0.35
0.30
0.25
0.20
0.15
0.10
0.05
0.00
A TRIFOCAL DESIGN: Elevated Phase Shift * (EPS) technology
Medicontur‘s proprietary, patented approach to trifocality uses EPS in the central part of the optic to generate constructive interference between the 0th (far) and 1st (near) diffractive order. This revolutionary optical design generates the 3rd focal point for intermediate vision in a very unique way:
THE MOST BALANCED TRIFOCAL IOL
EPS* technology uses only 7 rings within a 3 mm diameter for complete spectacle independence, improved image quality and excellent performance at near and far.
7 steps to Trifocal perfection
LIBERTY IOLs achieve trifocal performance with
7 steps in a precise diffractive array within a 3 mm diameter leaving a 75% refractive lens surface.
LIBERTY IOLs are strongly pupil dependent using the NEAR TRIAD which implies miosis under accommodation. We believe that too much light distribution into the near focus above 3 mm aperture does not match normal ocular physiology.
The 4 charts below show the Useful Light Distribution in % of LIBERTY and 3 competitors depending on the aperture [mm] *. LIBERTY provides the highest light distribution in the near focus under accommodation and the highest for far vision under scotopic conditions.
100 %
50 %
0 %
2.0 2.5 3.0 3.5 4.0 4.5 5.0
Liberty
Aperture (mm)
100 %
50 %
0 %2.0 2.5 3.0 3.5 4.0 4.5 5.0
Competitor 1 quadrifocal
Aperture (mm)
100 %
50 %
0 %2.0 2.5 3.0 3.5 4.0 4.5 5.0
Competitor 2 trifocal apodized
Aperture (mm)
100 %
50 %
0 %2.0 2.5 3.0 3.5 4.0 4.5 5.0
Competitor 3 trifocal non-apodized
Aperture (mm)
* Based on Strehl ratio calculated from Zemax simulated MTF values
Far Near Inter
6
1. TRIFOCAL PERFORMANCE *2. COMPLETE SPECTACLE INDEPENDENCE *3. EXCELLENT FAR – NEAR & GOOD INTERMEDIATE VISION *4. REFRACTIVE PREDICTABILITY & LONG TERM STABILITY *5. OUTSTANDING CONTRAST SENSITIVITY *6. EXCELLENT READING SPEED *7. MINIMAL REPORTS OF DYSPHOTOPSIA *
” The most balanced trifocal IOL on the market.“
M. Assouline, MD, PhD France
APAO 2018, Hong Kong
10CLINICALSTUDIES
IN
12 COUNTRIES
MORE THAN
900 EYES
100
80
60
40
20
0
Per
cent
age
of p
atie
nts
(%)
9692
49644
4
Very Satisfied Satisfied Rather satisfied
95%of patients
HIGHLY SATISFIED
at all distances (study C)
* Confirmed by studies; see references.
THE MOST BALANCED TRIFOCAL IOL
TRIFOCAL performance and Spectacle Independence
Clinical evidence shows excellent far & near, good intermediate vision.
Outstanding Visual Performance for Liberty 677MY (Study C)
Equivalent Clinical Visual Acuity compared to FineVision (PhysIOL) (Study B)
1.6
1.4
1.2
1.0
0.8
0.6
0.4
0.2
0 1.00
0.70
0.40
0.20
0.10
0.00
-0.10
-0.15
-0.20
2.0 1.5 1.0 0.5 0.0 -0.5 -1.0 -1.5 -2.0 -2.5 -3.0 -3.5 -4.0
Vis
ual A
cuit
y (d
ecim
al) V
isual Acuity (logM
AR
)
Diopters
Binocular Defocus curve (24-month follow-up)
1.2
1.0
0.8
0.6
0.4
0.2
0.0
67 cm
+4.0 +3.5 +3.0 +2.5 +2.0 +1.5 +1.0 0.0 -0.5 -1.0 -1.5 -2.0 -2.5 -3.0 -3.5
Vis
ual A
cuit
y (d
ecim
al)
Liberty 677MYDiopters FineVision (PhysIOL)
1.00
0.70
0.40
0.20
0.10
0.00
-0.10 Visual A
cuity (logMA
R)
8
THE MOST BALANCED TRIFOCAL IOL
High Image QUALITY
Superior Contrast Sensitivity compared to FineVision (PhysIOL) in different light conditions. (Study B, C)
0.0
0.5
1.0
1.5
2.0
2.5
Spatial frequencySpatial frequency
3 6 12 18
PHOTOPIC
CYC/DEG CYC/DEG CYC/DEG
MESOPIC SCOTOPIC
Log
Con
tras
t Se
nsit
ivit
y
Liberty 677MY (Medicontur) FineVision (PhysIOL)
3 6 12 18
Spatial frequency
3 6 12 18
Equivalent Contrast Sensitivity to Bi-Flex
Monofocal IOL (Study E)
Equivalent Reading Speed to Bi-Flex
Monofocal IOL (Study E)
„After over 100 implantations trifocal performance is evident. Less halos & glare, better contrast sensitivity. All my patients implanted with Liberty are spectacle independent.“ J. Győry, MD, Hungary ESCRS 2017, Lisabon
1.7
1.6
1.5
1.4
1.3Log
Cont
rast
Sen
siti
vity
Liberty 677MY
Pelli-Robson Contrast Sensitivity
Bi-Flex 677AB
Log
Cont
rast
Sen
siti
vity
Liberty 677MYBi-Flex 677AB
CSV-1000
0.4
0.6
0.20 3 6 9 12 15 18
0.8
1.0
1.2
1.4
1.6
1.8
2.0
CYC/DEG
Liberty 677MYBi-Flex 677AB
100
120
140
160
180
200
220
Wor
ds p
er m
inut
e
ACCURACY & PREDICTABILITY
Accuracy of refractive outcome of Liberty overshadow distinctively literature average = ±0.5 D: 75.1%.
Excellent Long Term Refractive Stability and Visual Outcomes. (Study C)
Mean spherical equivalent residual error of -0.15D (± 0.33D) (Based on studies A, C, D)
Cooke DL, Cooke TL. J Cataract Refract Surg. 2016;42(8):1157-1164
UCVA vs BCVA
Uncorrected Corrected
Cumulative Snell Visual Acuity (20/40 or better)
DISTANCE
TIM
E
INTERMEDIATE NEAR
2 3 1 4
0 0
0 0
2 3
1 2
1 2
1629
67
19
4456
85 8997 93
99 100
100 100 100 100 100 100 100 100
100 1001001009397
7359
37
90 95 100
10096
20
44
63
37
57
80
98 9593 9095
77
47
2600
100 100 100 100
100 100 100 100
20/12.5 20/16 20/20 20/25 20/32 20/40
20/12.5 20/16 20/20 20/25 20/32 20/40
20/12.5 20/16 20/20 20/25 20/32 20/40
20/12.5 20/16 20/20 20/25 20/32 20/40
20/12.5 20/16 20/20 20/25 20/32 20/40
20/12.5 20/16 20/20 20/25 20/32 20/40
100
80
60
4020
0
100
80
60
4020
0
3 M
onth
s P
osto
pCu
mulat
ive pe
rcent
of ey
es (%
)12
Mon
ths
Pos
top
Cumu
lative
perce
nt of
eyes
(%)
88%of Eyes≤ ± 0.50D
Refractive Stability and Predictability
Single use injection system for Liberty 677PMY preloaded IOLs
* Other powers upon request** Patent pending *** It is recommended that surgeons personalize the constants they use.
Type Single-piece hydrophilic intraocular lensfor implantation into the capsular bag
Material 25% water content with UV absorber + blue light filter; Refractive Index 1.46; ABBE number 58
Optic design Biconvex, aspheric, diffractive-refractive, apodized
Powers available* +8.00 D +35.00 D (increment: 0.50 D)
Diffractive zone EPS technology**, anterior surface, Ø 3.0 mm
Addition +3.50 D (near); +1.75 D (intermediate)
A-constant*** 118.9 (SRK/T)
Dimensions Overall length 13.0 mm; optic Ø 6.0 mm
PCO protection 360° Special Square Edge (patented)
Haptic angulation 0° – asymmetrical design with posterior vaulting
Sterilization Steam (shelf life 5 years after sterilization)
Storage conditions at +15 °C – +35 °C (15% – 50% humidity)
Liberty 677MY / 677PMY Technical Specification
1st CLICK LOADING1. Put a drop of visco in the lens holder2. Insert the injector into the wet container
3rd CLICK READY5. Push the red stopper forward to the end position6. Fill visco
2nd CLICK CLOSING3. Inject viscoelastic material into the cartridge nozzle
4. Fold up the cartridge nozzle
INJECTION7. Push the plunger midway then pull back to the end and continue pushing
A LEADING HAPTIC DESIGN FOR ROTATIONAL STABILITYPCO PROTECTION 360° posterior optic edge (≤ 10 um edge radius)
ROTATIONAL STABILITY Ergonomic-adaptive fit with optimal balance in haptic force – DOUBLE LOOP HAPTIC
180° contact angle between haptic and the capsular bag equator at 9 mm Ø
PREMIUM MATERIAL & ADVANCED
MANUFACTURING TECHNOLOGY
SAFETY RECORDS 30 years experience in IOL design
and manufacturingIMAGE QUALITY
Highest ABBE no. (58) for the lowest chromatic aberrationPCO protection
Low ionicity surface for less cell adhesionRETINA PROTECTION
UV blocker Violet light filtering
TRIFOCAL PERFORMANCE – SPECTACLE INDEPENDENCEHIGH QUALITY OF VISION
7 steps in a precise diffractive array with a 3 mm diameter leaving a
75% refractive lens surface Minimal dysphotopic phenomena
Superior contrast sensitivity Uncompromised near vision
PUPIL DEPENDENT using physiological NEAR TRIAD
Material. Design. Optics.
* Other powers upon request** Please note that at SEQ.: +8.0 D to +9.5 D, only cyl. +1.0 D to +4.5 D applies.*** Patent pending**** It is recommended that surgeons personalize the constants they use.
TypeSingle-piece hydrophilic trifocal toric intraocular lens for implantation into the capsular bag
Material25% water content with UV absorber + blue light filter; Refractive Index 1.46; ABBE number 58
Optic design Biconvex, aspheric, diffractive-refractive, apodized, toric
Powers available* +8.00 D +35.00 D (increment: 0.50 D)
Cylinders available**
+1.00 D +4.50 D (increment: 0.50 D)+5.25 D; +6.00 D
Diffractive zone EPS technology***, anterior surface, Ø 3.0 mm
Addition +3.50 D (near); +1.75 D (intermediate)
A-constant**** 118.9 (SRK/T)
Dimensions Overall length 13.0 mm; optic Ø 6.0 mm
PCO protection 360° Special Square Edge (patented)
Haptic angulation 0° – asymmetrical design with posterior vaulting
Sterilization Steam (shelf life 5 years after sterilization)
Storage conditions at +15 °C – +35 °C (15% – 50% humidity)
Liberty 677MTY Technical Specification
THE MOST BALANCED TRIFOCAL IOL
liberty-lens.com
References A. AF, Dunai et al. (Hungary) Comparison of two multifocal IOL Types (50 Bi-Flex M &50 Acrysof IQ) – long term visual outcome. ESCRS 2016, 2017. B. E. Van Acker, MD, (Belgium) Comparison of clinical outcomes and patient satisfaction after implantation of two different types of diffractive apodized IOLs: 40 Bi-Flex M (based on PAD technology) 40 Finevision (Micro F) trifocal diffractive IOL. Prospective, randomized, observational study. ESCRS 2017. C. J. Györy (Hungary) Long term funcional and morphological outcomes and patient satisfaction after cataract surgery with 100 BiFlex M implantation with/without posterior central circular capsulorhexis (PCCC). ESCRS 2016, 2017. D. J. Fernandez MD, PhD, (Spain) Visual performance of patients implanted with progressive PAD Bi-Flex M analyzed by the Qvision iPAD Multifocal LensAnalyzer. ESCRS 2017. E. E. Law et al. (UK) Randomised clinical trial of the Bi-Flex M multifocal intraocular lens. ESCRS 2017. F. A Dexl. (Austria) Visual Outcome, Patient Satisfaction and Spectacle Independency after Implantation of 50 eyes ith Progressive Bi-Flex M. Final Result of a Multicentric Trial with 50 Conscecutive Patients. ESCRS 2015. G. C. Naval. (Philippines) Evolution of multifocal practice. ESCRS 2014. H. N. Meijide (Argentina) Visual Outcomes After Bilateral Implantation of a New Progressive Apodized Diffractive Trifocal IOL. Clinical outcome ASCRS 2018 ID 42517. I. J. García-Bella et al. (Spain) Visual outcomes after progressive apodized diffractive intraocular lens implantation. Eur J Ophthalmol. 2017 Sep. J. M. Assouline MD, PhD, (France) Comparative Outcome of Four Multifocal Intraocular Lens. ESCRS 2015.
MediconturMedical Engineering [email protected]
Head OfficeHerceghalmi Road 1.2072 ZsámbékHungary
International OfficeChemin des Aulx 181228 Plan-les-OuatesGeneva/Switzerland
LESS STEPS – MORE VISION
”Exceptionally good platform and an optic that generates more patient satisfaction in terms of defocus curves and perceived dysphotopsia symptoms. I would not change a thing about this IOL.“
J. Fernandez MD, PhD, Spain WOC 2018, Barcelona
FOCUSon the patients visionsince 1989
Medicontur stands for consistent high quality, proven by more than
6 millionintraocular lensesimplanted.
„Clinical evidence of prospective randomized study catapulted Liberty into the high quality trifocal group of IOLs available on the market.“
E. Van Acker, MD, Belgium ESCRS 2017, Lisabon
TRIFOCAL Complete Spectacle Independence
7 RINGS TO PERFECTIONSuperior Contrast Sensitivity