01
multiSert™ 4-in-1 Modes
Choose push or screw advancement mode; set insert shield to default (delivery into capsular bag) or advanced position (delivery through incision tunnel). Consistent mode selection reduces case-to-case variability.20
02
iSert® Delivery
Lubricate tip with OVD. Advance plunger smoothly — no stop-start motion. Both iSert® and multiSert™ use 1.70 mm injector tip OD and require ≥2.20 mm incision.
03
Toric Axis Alignment
Mark horizontal meridian with patient seated upright to compensate for cyclotorsion. Use HOYAtoric.com — supports Abulafia-Koch regression for posterior corneal astigmatism correction.22 Axis orientation marks are on the posterior surface of the XY1A-SP.
04
Capsulorrhexis for Gemetric™
Target a centred, circular CCC of 5.0–5.5 mm with 360° optic overlap. Precise centration is critical — the diffractive zone occupies the central 3.2 mm; decentration degrades trifocal performance.
05
OVD Removal — Toric
Complete OVD removal, including posterior to the optic, before confirming final toric axis position. Any residual OVD permits rotation. Final check must follow full OVD aspiration.
06
PCO Prophylaxis
Vivinex™ uses a three-layer approach: active oxygen treatment + smooth optic surface + 360° square posterior edge. Full CCC overlap of optic edge maximises barrier effect. Evidence: Leydolt et al. 202013; Auffarth et al. 202312.