EDOF Lenses Make Their Mark in French Market

Hydrophobic lenses most implanted overall. Dermot McGrath reports

Asteady increase in the number of female ophthalmologists and a dramatic rise in the popularity of extended depth of focus (EDOF) IOLs were some of the more pertinent findings of the latest survey of French ophthalmologists conducted by Raphaël Barugel MD and Dominique Monnet MD.

“The increasing preference for EDOF lenses is one of the more notable features of this year’s survey, with 44% of surgeons saying they would select an EDOF lens for their own cataract surgery,” Dr Barugel said.

The latest study of French practice habits carries on the work by Richard Gold MD for the past 25 years—which provided an important gauge for surgeons to see how their own techniques and choices compared to their peers, Dr Barugel explained.

“It was also useful to be able to compare to practices in other countries and innovative in that it also surveyed the choices surgeons would make for their own eyes as well as those of their patients,” he said.

While Dr Gold’s annual survey covered a broad spectrum of practice habits, Drs Barugel and Monnet opted to limit the questions to a particular aspect of cataract and refractive surgery each year, with the 2022 survey focusing on intraocular lenses.

The mean age of the 155 respondents to the 2022 survey was 49 years, with 69% male and 31% female, with over half (61%) working in private practice and 14% within a hospital setting.

“The study showed an increase in the number of female ophthalmologists: the figure was 36% for those younger than 50 compared to 24% for those over 50 years of age,” Dr Barugel said.

The vast majority of respondents (96%) said they practiced at least one other type of surgery in addition to cataract, with refractive (68%) and glaucoma (44%) the most common surgeries. About one-third (34%) performed less than 300 surgeries a year, while 37% performed more than 500 operations annually.

In terms of the type of IOL implanted, most respondents used hydrophobic lenses (71%), with 70% saying refractive predictability was the most important criteria in their lens choice, followed by capsular bag stability (50%), and having a pre-loaded implant (39%).

For IOL power calculation formulae, 87% of respondents said they used the SRK/T formula, followed by Barrett (43%), Hoffer Q (33%), and Haigis (28%). Some 61% of respondents said they routinely use at least two different formulae, with Haigis, ASCRS calculator, and Barrett the most used formulas for post-refractive surgery patients.

The threshold for implantation of a toric lens was astigmatism of less than 1.25 D for 80% of those surgeons who implanted toric IOLs when it was possible to do so versus 32% who said they implant these lenses only occasionally.

The main barriers to implantation for those who never implant toric lenses were uncertainty about the outcome (68%), the extra cost to the patient (43%), and increased consultation time (57%). The three most important criteria in the choice of a toric implant were postoperative rotational stability (80%), ease of IOL rotation into position when implanting the lens (54%), and the absence of or minimal extra cost to the patient (46%).

When surgeons were asked about their choices if undergoing cataract surgery themselves, 86% said they would pick their own implants, with 44% preferring an EDOF lens, 40% a monofocal, and 16% a multifocal IOL. The key criteria orienting their choice of IOL were quality of vision and the risk of side effects (92%), spectacle independence (67%), and IOL material (49%).

Dr Barugel presented the study at the French Implant and Refractive Surgery Association (SAFIR) Annual Meeting in Paris.

Raphaël Barugel MD is an ophthalmologist at the Quinze-Vingts Eye Hospital, Paris, France. rbarugel@yahoo.fr

Ready when you are.

Continue your education all year with our range of online resources. Visit education.escrs.org