Alcon has now rolled out its Clareon material across its IOL range, becoming a defining feature that surgeons say is offering improved clarity and confidence.
Alcon’s AcrySof Vivity was already addressing an unmet need for cataract surgeons across the country when it launched locally in 2021. Now, with the introduction of the Clareon Vivity, ophthalmologists have added confidence in terms of the long-term performance of an already “industry disrupting” lens.
For surgeons across the country, Alcon’s Vivity intraocular lens (IOL) represented a new dawn for the presbyopia-correcting category by offering excellent distance, intermediate and functional near vision along with a monofocal-like visual disturbance profile. The lens recently surpassed one million implants worldwide and has gone on to become the most implanted extended depth-of-focus (EDOF) IOL.
Now, it joins the suite of Alcon IOLs on the company’s most advanced material yet – the Clareon hydrophobic acrylic. The material was derived from the AcrySof hydrophobic polymer and retains many of the same mechanical properties, while enhancing material characteristics. This includes improved optical clarity and reduced glistenings by increasing equilibrium water content to 1.5%, improving milled edge profile, and a manufacturing process that reduces surface roughness and material inconsistencies.
Australian ophthalmologists Dr Uday Bhatt and Dr Tim Roberts were among the first to assess the material’s performance. In a study published in 2023, they found at three years, 100% of eyes implanted with the Clareon IOL presented with Grade 0 glistenings; and 92.9% of eyes (394/424) had either no posterior capsular opacification (PCO) or clinically non-significant PCO. Visual outcomes were excellent and stable over the three-year study period.
Clareon first became available to Australian ophthalmologists as a monofocal in 2018, followed by the toric version in 2020 and PanOptix in 2023. Within the monofocal range, Alcon has launched Clareon AutonoMe in an extended range of T2-T6 in 25.5D – 30D which is now available across Australia and New Zealand. With the addition of Clareon Vivity, Alcon’s IOLs have now completed the transition to the new material, offering an elevated level of confidence and clarity for surgeons and patients, respectively.
Retina and cataract surgeon Dr Angela Jennings from personalEYES in NSW is among early adopters of the Clareon Vivity and has been implanting the lens in patients since November 2023.
Although the AcrySof Vivity has been praised by surgeons and patients alike, Alcon uncovered an opportunity to advance the technology further, something Dr Jennings and her patients have welcomed.
As reported, Clareon has been designed to avoid a glistening effect that can occur when microvacuoles form within the IOL material, causing light to scatter and create a sparkling or shimmering effect. For AcrySof IOLs, this was a concern among some surgeons as, over time, glistenings may contribute to a degradation in quality of vision.
Dr Jennings says Clareon Vivity delivers the same, high-quality refractive outcomes as its AcrySof predecessor, but with an added level of clarity and without concern over glistenings.
“It’s not prone to that photic phenomenon, glistenings within the material and surface haze. That’s the reason the Clareon is going to give you such a clear vision,” Dr Jennings says.
“In terms of what people can read on the distance chart, we wouldn’t notice an awful lot of difference between the two lenses. But in terms of what they feel about the clarity of the vision, there is certainly an advantage from what I’ve seen.”
Dr Jennings is no stranger to Alcon IOLs and the Clareon material, as they feature heavily within her armamentarium.
“If I’ve got a reason for wanting to put in a monofocal or monofocal toric lens in someone with a lot of macular pathology, for example, Clareon has been my go-to.”
Similarly, NSW cataract, corneal and refractive surgeon Dr Armand Borovik has found Clareon Vivity to be a go-to lens, providing an added layer of confidence that there’s unlikely to be any long-term and adverse effects.
“As a surgeon, it gives you more confidence to use it in younger patients. You’re more concerned about the longevity of the lens material because they have more years of vision left,” he says.
Dr Borovik says with Clareon he has no reservations about the suitability of the material.
Dr Jennings adds: “The Clareon reduces concerns, and you can be very confident with the clarity of the vision. Vision quality is not expected to degrade with time as the lens material is very stable.”
“Surgeons want the best possible outcomes for their patients, with excellent refractive results, clarity of vision, quality of life and long-term stability. This lens performs very predictably and to an excellent standard on all fronts.”
Dr Jennings says Clareon Vivity allows patients to perform daily activities, such as using a smartphone, without the need for glasses.
Particularly for patients with healthy eyes, it offers a level of independence from glasses that enhances their quality-of-life.
She also notes the benefits for the ageing population, as reducing dependence on multifocal glasses can lower the risk of falls and improve overall day-to-day visual function. Meanwhile, Dr Jennings is enthusiastic about the future of Clareon Vivity.
“Now that we’re going to have free access between them, I think it’s quite likely that I will shift to preferring the Clareon Vivity platform over the previous materials,” she says.
She believes the transition will be seamless for surgeons who have previously used AcrySof Vivity lenses, and that those who were hesitant due to concerns about the materials should consider the Clareon upgrade.
Dr Borovik describes the Clareon Vivity as his “workhorse lens”, and a reliable choice for the majority of his patients.
“I default to that lens and only move outside of Clareon Vivity if the patient is not suitable for an EDOF lens or if they specifically want a multifocal lens,” he says.
In some patients, Dr Borovik has implanted Clareon monofocal in one eye and AcrySof in the other. He says usually they prefer the clarity of the Clareon. The lens’ forgiving side effect profile and high patient satisfaction make it a staple in his practice. He believes that not offering PC-IOLs does a disservice to patients, as the vast majority are suitable candidates for these advanced IOLs.
“My explant rate remains zero,” Dr Borovik says.
He notes that anecdotally, patients may achieve slightly better intermediate or near vision with Clareon, though he acknowledges that this observation requires further study. Despite this, he confidently defaults to Clareon for all suitable patients.
More reading
Alcon’s Clareon PanOptix IOL offers a new level of clarity
Alcon’s Vivity IOL achieves major global milestone
How Alcon’s Vivity is disrupting the Australian IOL landscape
