I have been implanting the Vivinex Gemetric IOLs (HOYA Surgical Optics) since 2020 when I was involved in early clinical trials. At the trials’ conclusions, I was suitably impressed enough to keep using the Vivinex Gemetric (G) and Vivinex Gemetric Plus (GP) lenses when they became commercially available. I now routinely use both lenses in my clinical practice.
I implant the combination of Vivinex Gemetric and Vivinex Gemetric Plus (G-GP) IOLs in those patients with high motivation to achieve spectacle independence. Patients with retinal or corneal disease, severe dry eye disease, an endothelial cell count below 1,500 cells/mm2, irregular astigmatism, traumatic cataract, strabismus, amblyopia or single eye status, and pupil abnormalities are, of course, excluded.
In terms of how to use the lenses, I quickly noticed that the pairing of G-GP provides my patients with the best quality of vision, particularly at far distance when compared to the bilateral implantation of GP-GP. Pairing G-GP also provides a broader range of continuous high-quality vision than implanting bilateral G-G alone. As a result, I now perform contralateral paired implantation of Vivinex Gemetric and Vivinex Gemetric Plus lenses routinely.
All of my patients are very happy with this approach. Unlike those commonly practiced mix-and-match technologies that make use of different add powers, I do not believe that considering eye dominance has a material impact on outcomes or patient satisfaction. Patient complaints of dysphotopsias are less or similar to the many other trifocal platforms I have used.
I recently evaluated data from 30 of my paired G-GP patients (mean age: 66.26 ±11.33 years). The main evaluation endpoints were uncorrected and corrected binocular distance, intermediate, and near visual acuities; contrast sensitivity; and aberrations. The implanted IOL power range was between 18.00 and 26.00 D, and 20% of patients received a toric version.
The visual acuity outcomes when implanting G-GP contralaterally are seen in Figure 1. Vision was very good at all distances, especially for near and far distances. The defocus curve for visual acuity results from my patients was greater than 0.15 logMAR for 3.50 D (Figure 2), which was similar to that of the multicenter clinical study.
Figure 1. Binocular visual acuity outcomes with pairing Vivinex Gemetric (G) and Vivinex Gemetric Plus (GP) IOLs (30 Patients; more than 6 months postoperative).
Figure 2. Binocular defocus curve of paring Vivinex Gemetric (G) and Vivinex Gemetric Plus (GP) IOLs shows broad range of vision (30 Patients; more than 6 months postoperative).
Additionally, contrast sensitivity in both photopic and mesopic conditions was high (Figure 3). At 6 months, eyes demonstrated low levels of aberrations (HOA 0.09 ±0.05 µm, LOA 0.30 µm ±0.14 µm, and SA 0.01 ±0.02 µm, respectively), as measured with the Pentacam AXL Wave (Oculus Optikgeräte).
Figure 3. High levels of contrast sensitivity achieved by patients with pairing Vivinex Gemetric (G) and Vivinex Gemetric Plus (GP) IOLs (30 Patients; more than 6 months postoperative).
With so much confidence in the results with contralateral implantation of G-GP, I have expanded the use of this combination in very carefully selected patients after myopic LASIK ablation with very positive outcomes.
CONCLUSION
Eyes implanted with Vivinex Gemetric and Vivinex Gemetric Plus have high levels of contrast sensitivity and low levels of aberrations. I can provide my patients with a broad range of continuous, high-quality vision outcomes by pairing Vivinex Gemetric and Vivinex Gemetric Plus.
