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.

Lens

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.

Injector

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).⁵

For detailed instructions, please see the technical guides for each of the lenses:

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.⁶

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.⁶

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.⁶

The ideal IOL should:

• Provide high levels of corrected visual acuity (CVA)¹
• 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/wastage¹
• Quickly and fully regain its mechanical and optical properties after injection¹
• Assume a stable position within the eye and have a low risk of misalignment¹
• Experience little or no impact on visual function at common levels of misalignment¹
• Be associated with a relatively low risk of post-operative complications, such as posterior capsule opacification (PCO) and endophthalmitis¹
• Have a low propensity for glistening and general deterioration over time¹

• +6.0 to +26.0 dioptre:
  +6.0 to +10.0 dioptre (1.0D increments)
  +10.0 to +26.0 dioptre (0.5D increments)⁴

• +6.0 to +30.0 dioptre:
  +6.0 to +10.0 dioptre (1.0D increments)
  +10.0 to +30.0 dioptre (0.5D increments)³

• +6.0 to +26.0 dioptre:
  +6.0 to +10.0 dioptre (1.0D increments)
  +10.0 to +26.0 dioptre (0.5D increments)⁷

Yes

Yes, Avansee does not contain metal.

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°.⁸

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.⁶

Avansee undergoes a stringent manufacturing process that ensures a uniform, high density of cross linkages in the optic polymer.⁶

Compared to some other IOLs, Avansee has a low propensity to absorb water due to changes in temperature (see Confidence).⁹

Avansee was first launched in Japan in 2007. 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 2013/2014.¹

AvanseePreset PN6A and PU6A was originally launched in Germany and Italy in 2014, Switzerland in 2015, Benelux in 2016, Austria (Andre) in 2017, Greece (Eyelens) in 2018 and France (Medicare) in 2019.¹⁰

The most recent additions to Kowa’s growing ophthalmology portfolio are the Avansee Preload1P and Avansee Preload 1P Toric injectors, The 1-piece lens and injector system was launched in Japan in October 2016 and entered the European market in early 2017 as Avansee Preload1P¹⁰ and in early 2020 as Avansee Preload1P Toric. See the Kowa in Ophthalmology section to locate your nearest distributor.