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
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 high quality trifocal group of IOLs available on the market.“
E. Van Acker, MD, Belgium
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 functional 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 with 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 QUALITYOF 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 compromiseIOL performance.
Liberty equates to spectacle independence without the compromise of reduced image quality or visual acuity at near and far distances.
LIBERTYFOR YOUR PATIENTS
Liberty-brochure-13.indd 1Liberty-brochure-13.indd 1 17.09.18 20:2817.09.18 20:28
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 fi gures demonstrate the difference in light scattering and energy loss on two separate diffractive IOL profi les.
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 diff ractive steps Moderate light scattering
Figure 1b:Diff ractive optic with2× more diff ractive stepscreates minimum3× more light scattering
Liberty-brochure-13.indd 2Liberty-brochure-13.indd 2 17.09.18 20:2817.09.18 20:28
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 aft er custom defi ned diff ractive 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 (um)
Distance from optical axis (um)
Distance from optical axis (um)
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 (um
)
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 1.0
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 (um
)
150
100
50
0
-50
-100
-150
Competitor 1 - quadrofocal
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 (um
)
150
100
50
0
-50
-100
-150
Competitor 2 – trifocal apodized
Liberty-brochure-13.indd 3Liberty-brochure-13.indd 3 17.09.18 20:2817.09.18 20:28
4
Figure 2: MTF through focus curves with central diff ractive phase shift s at a destructive and a constructive interference level resulting in a 3rd focal point for intermediate vision.
Figure 1: Radial profi le with central diff ractive phase shift elevated from a destructive level to a constructive interference level.
Ph
ase
Shif
t (
)
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 0 (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.
Liberty-brochure-13.indd 4Liberty-brochure-13.indd 4 17.09.18 20:2817.09.18 20:28
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 1.0
Aperture (mm)
100 %
50 %
0 %2.0 2.5 3.0 3.5 4.0 4.5 5.0
Competitor 1 quadrofocal
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 Zemax simulation results, PMTF calculation method and on Strehl ratio calculated from Zemax simulated MTF values.
Far Near Inter
Liberty-brochure-13.indd 5Liberty-brochure-13.indd 5 17.09.18 20:2817.09.18 20:28
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, PhDFrance
10CLINICALSTUDIES
MORE THAN
928 EYES
MORE THAN
615HAPPYPATIENTS
100
80
60
40
20
0
Per
cen
tag
e of
pat
ien
ts (%
)
9692
49644
4
Very Satisfied Satisfied Rather satisfied
95%patientsHIGHLY
SATISFIEDat all distances
(study C)
* Confi rmed by studies; see references.
Liberty-brochure-13.indd 6Liberty-brochure-13.indd 6 17.09.18 20:2817.09.18 20:28
THE MOST BALANCED TRIFOCAL IOL
TRIFOCAL performanceand 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)
-0.1
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.72.0 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
Acu
ity
(log
MA
R)
Diopters
1.2
1.0
0.8
0.6
0.4
0.2
0.0
67 cm
+4.0D +3.5D +3.0D +2.5D +2.0D +1.5D +1.0D 0.0D -0.5D -1.0D -1.5D -2.0D -2.5D -3.0D -3.5D
Vis
ual
Acu
ity
(dec
imal
)
Liberty 677MYDiopters Micro F (PhysIOL)
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8
THE MOST BALANCED TRIFOCAL IOL
High Image QUALITY
Superior Contrast Sensitivity compared to FineVision (PhysIOL) in different light conditions. (Study B, C)
8
6
7
5
4
3
2
1
00 3 6 9 12 15 18 0 3 6 9 12 15 18 0 3 6 9 12 15 18
CYC / DEG
PHOTOPIC MESOPIC SCOTOPIC
CYC / DEG CYC / DEG
CSV
-10
00
Sco
res
Liberty 677MY (Medicontur) Micro F (PhysIOL)
Equivalent Contrast Sensitivityto Bi-Flex
Monofocal IOL (Study E)
Equivalent Reading Speedto Bi-Flex
Monofocal IOL (Study E)
„Aft er 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.
1.7
1.6
1.5
1.4
1.3Log
Con
tras
t Se
nsi
tivi
ty
Liberty 677MY
Pelli-Robson Contrast Sensitivity
Bi-Flex 677AB
Log
Con
tras
t Se
nsi
tivi
ty
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
per
min
ute
Liberty-brochure-13.indd 8Liberty-brochure-13.indd 8 17.09.18 20:2817.09.18 20:28
A LEADINGHAPTIC DESIGNFOR ROTATIONALSTABILITYPCO PROTECTION 360° posterior optic edge (≤ 10 um edge radius)
ROTATIONAL STABILITY Ergonomic-adaptive fi t with optimal balancein haptic force – DOUBLE LOOP HAPTIC
180° contact angle between hapticand the capsular bag equator at 9 mm Ø
PREMIUM MATERIAL &ADVANCED
MANUFACTURING TECHNOLOGY
SAFETY RECORDS 20 years on the market
(since 2010 for trifocal IOLs)
IMAGE QUALITY Highest ABBE no. (58) for the lowest chromatic aberration
PCO protection Low ionicity surface for less cell adhesion
RETINA PROTECTION UV blocker
Violet light fi ltering
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.
Liberty-card-1-MDO-03.indd 1Liberty-card-1-MDO-03.indd 1 17.09.18 21:1917.09.18 21:19
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. Please fi nd more information about IOL constants on ULIB. http://www.ocusoft .de/ulib/c1.htm)
Type Single-piece hydrophilic intraocular lensfor implantation into the capsular bag
Material 25% water content with UV absorber + blue light fi lter Refractive Index 1.46 – ABBE number 58
Optic design Biconvex, aspheric, diffractive-refractive, apodized
Powers available* 8.0 D +35.0 D · (increment: 0.5 D)*
Diffractive zone EPS technology**, anterior surface, Ø 3.0 mm
Addition +3.5 D (near); 1.75 D (intermediate)
A-constant*** 118.9 (SRK/T)***
Dimensions Overall length 13.0 mm; optic Ø 6.0 mm
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)
1st CLICK LOADING
Insert the injectorto thewet container
3rd CLICK READY
Push the redstopper forwardto the endposition andfi ll visco
2nd CLICK CLOSING
Fold up the cartridgenozzle
INJECTION
Push the plunger midwaythen pull back 1–2 mm and continuepushing
SING
ge
nger midwayk 1–2 mm
DY
Liberty 677PMY Technical Specifi cation
Liberty-card-2-Data-Sheet-03.indd 1Liberty-card-2-Data-Sheet-03.indd 1 17.09.18 20:5617.09.18 20:56
ACCURACY & PREDICTABILITY
Accuracy of refractive outcome of Liberty overshadow distinctivelyliterature 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
40
20
0
100
80
60
40
20
0
3 M
onth
s P
osto
pCu
mula
tive p
ercen
t of e
yes (
%)12
Mon
ths
Pos
top
Cum
ulativ
e perc
ent o
f eye
s (%)
88%of Eyes
≤ ± 0.50D
Refractive Stability and Predictability
Liberty-card-3-Graph-02.indd 1Liberty-card-3-Graph-02.indd 1 18.09.18 12:0618.09.18 12:06
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 functional 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 with 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
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 high quality trifocal group of IOLs available on the market.“
E. Van Acker, MD, Belgium
TRIFOCAL Complete Spectacle Independence
7 RINGS TO PERFECTIONSuperior Contrast Sensitivity