Frequently asked questions (FAQs)
What is the difference between AvanseePreset, Avansee Preload1P and Avansee Preload1P Toric?
All are preloaded IOL injector systems that allow quick, accurate and consistent IOL placement. They differ in two main parts, the lens and the injector.
All three lenses are manufactured from the same UV-absorbing, hydrophobic, soft acrylic material, which is glistening free and has an excellent long-term safety record. However, the AvanseePreset contains a 3-piece (3P) lens, whereas the Avansee Preload1P and Avansee Preload1P Toric utilises a 1-piece (1P) lens.
The 3P IOL has C-loop haptics made from soft, flexible polyvinylidene fluoride (PVDF).1 Both the 1P lenses have a smooth 360° lens surface that extends around the optic-haptic junction.2 The 1P lens can be injected through smaller incisions (2.2–2.4mm)3, compared to the 3P lens (2.4–3.0mm)4.
The injectors share many common features but have been specifically designed to partner their particular lens. The Avansee Preload1P and the Avansee Preload1P TORIC injector is based on the original design of AvanseePreset. The unique plunger allows great control and lens stability during IOL insertion. The angled nozzle consistently releases the lens in the correct position (see Control pages).
What steps should be taken during IOL insertion?
What are the common issues during insertion?
- Plunger cannot be removed from eye
- Push the plunger fully forward, ensure the bevelled nozzle is pointing down and try to remove the plunger again.
- Trailing haptic is not released into the eye
- The plunger has not been pushed fully forward, so the haptic is stuck between the plunger and the nozzle. The plunger should be pushed forward to release the haptic.
- Plunger has been moved backwards
- This increases the possibility of further problems. Therefore, the product should be discarded, and a new injector should be used.
What are the characteristics of an ideal IOL?
The ideal IOL should:
- Provide high levels of corrected visual acuity (CVA)
- Be fully preloaded into an advanced injection system, allowing fast, reliable, reproducible, and controlled insertion through a small incision with a low risk of infection, and reduced levels of failure/wastage
- Quickly and fully regain its mechanical and optical properties after injection
- Assume a stable position within the eye and have a low risk of misalignment
- Experience little or no impact on visual function at common levels of misalignment
- Be associated with a relatively low risk of post-operative complications, such as posterior capsule opacification (PCO) and endophthalmitis
- Have a low propensity for glistenings and general deterioration over time
What dioptre range is available?
- +6.0 to +26.0 dioptre
- +6.0 to +10.0 dioptre (1.0D increments)
- +10.0 to +26.0 dioptre (0.5D increments)
Can patients with Avansee implants undergo MRI examination?
Can Avansee be used in patients with a metal allergy?
Yes, Avansee does not contain metal.
How common is IOL misalignment within the eye?
In clinical practice, the average displacement observed for IOLs in normal eyes is 30 ± 0.16mm and the average tilt is 2.62 ± 1.14°.5
Why is Avansee associated with a low risk of glistening/whitening?
Optics made from a stable, uniform and highly cross-linked polymer are less likely to allow water to gather into the microvoid of the material. Therefore, they are less susceptible to glistening and/or whitening.
Avansee undergoes a stringent manufacturing process that ensures a uniform, high density of cross linkages in the optic polymer.
Compared to some other IOLs, Avansee has a low propensity to absorb water due to changes in temperature4 (see Confidence).
In which markets has Avansee been launched?
Avansee was first launched in Japan in 20075. The initial 3P spherical models (AN6K, AU6K, and AN6MK) were followed by a fully pre-loaded, single-use spherical Avansee injector system (AvanseePreset PN6 and PU6) in 2010 and then by aspheric counterparts (AN6KA, AU6KA, AN6MA, PN6A, PU6A, PN6AS) in 2013/2014.
AvanseePreset PN6A and PU6A were launched in Germany and Italy 2014, Switzerland 2015, Benelux 2016.
The most recent addition to Kowa’s growing ophthalmology portfolio is the Avansee Preload1P. This 1-piece lens and injector system was launched in Japan in October 2016 and entered the European market in early 2017. See the Kowa in Ophthalmology section to locate your nearest distributor.