White Papers

The North America Clinical Development and Medical Affairs organization has authored publications on a variety of therapeutic and diagnostic topics.

These publications are intended to inform and educate eye care practitioners about ophthalmic medical disease states and technologies.

Please see a list of publications below.

An Overview of the Current Consensus, Clinical Impact and Management of Dry Eye

Faith McAllister, OD, MS*; Thao Yeh, OD, PhD, MPH, FAAO*

This paper discusses the etiology of dry eye, impact on clinical diagnosis and management and treatment options, including artificial tear solutions.

*Alcon Medical Affairs, North America, Fort Worth, TX

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Using ORA SYSTEM Technology with AnalyzOR Technology to Optimize Refractive Cataract Outcomes: Normal to Complex Cases, Simultaneous Innovations

Michael Breen, OD; Alvin Relucio, MD

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Effectiveness of Multipurpose Contact Lens Solutions Against Acanthamoeba Trophozoites

Jessica Mathew, OD, PhD, FAAO Alcon Medical Affairs; Monica Crary, PhD Alcon R&D Microbiology

This white paper discusses the risks of Acanthabmoeba and the effectiveness of contact lens multipurpose solutions against Acanthamoeba trophozoites.

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Precision1® Contact Lenses With Smartsurface® Technology: Material Properties, Surface Wettability and Clinical Performance

Jessica Mathew, OD, PhD, FAAO, Alcon Medical Affairs, North America

PRECISION1® (verofilcon A) daily disposable contact lenses are Alcon’s latest lens innovation and feature a unique water surface technology that creates a highly wettable and lubricious lens surface.

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Critical Preoperative Assessment to Improve the Outcome of Cataract Surgery

Xiaolin Gu, MD, PhD*; Li Wang, MD, PhD**

This white paper focus on the critical steps during preoperative assessment of cataract surgery that help surgeons to provide better visual outcomes and patient satisfaction.

*Alcon Medical Affairs, North America; Fort Worth, TX

**Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine

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IOL Lens Constant Optimization

Xiaolin Gu, MD, PhD; Li Wang MD, PhD; Michael Breen, OD; Mohinder Merchea, OD, PhD, MBA

This white paper shows how utilizing accurate Lens Constants for specific IOL models and employing an appropriate new generation IOL formula can improve the refractive outcome of a cataract procedure.

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Total30 Contact Lenses with Water Gradient and Celligent Technologies

Jessica Mathew, OD, PhD, FAAO, Alcon Medical Affairs, North America

TOTAL30® (lehfilcon A) contact lenses are the first and only monthly contact lenses with Water Gradient Technology and feature unique biomimicking properties.

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Factors Influencing the Design of Microsurgical Instrument Handles

George F. Castillo, MD*; Lejla Vajzovic, MD**; Reto Grüebler, PHD***

This white paper addresses the design principles applied and the features incorporated into the Alcon Grieshaber FINESSE REFLEX™ microinstrument handle, such as optimized handle diameter and actuation force, as well as increased instrument stiffness that have favorably affected the ease of use, and built upon the favorable 360-degree angular orientation of the prior-generation Alcon Grieshaber REVOLUTION® handle.

*Alcon Vision, LLC; Fort Worth, TX USA

**Duke University Eye Center; Durham, NC USA

***Alcon Grieshaber AG; Schaffhausen, Switzerland

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Characteristics of Smaller, High-Speed Vitrectomy Probes that Can Improve Efficiency and Safety

George F. Castillo, MD*; S.K. Steven Houston III, MD**

This white paper describes how small-gauge, high-speed, dual-blade vitrectomy probes can favorably affect surgical safety and efficiency. *Alcon Vision, LLC **Florida Retina Institute

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Tear Film Lipid Layer in Health, Disease, and Management

Thao N. Yeh, OD, PhD, MPH, FAAO
Alcon Medical Affairs, North America, Fort Worth, TX

This whitepaper describes the role of non-polar and polar lipids in the tear film, compositional and physical changes in meibomian gland dysfunction, and first-line and mainstay therapy options for managing those changes in MGD patients, including with BlephEx, Systane iLux, and Systane COMPLETE.

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Surgical Vitrectomy Consoles – The Principles Behind Their Operation

George F. Castillo, MD Alcon Vision, LLC, Fort Worth, TX

This white paper addresses the evolution and operating principles of popular surgical vitrectomy consoles on the market, today, to include the CONSTELLATION Vision System.

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Reaping the Benefits of Digitally Assisted Vitreoretinal Surgery

George F. Castillo, MD Alcon Vision, LLC, Fort Worth, TX

This white paper describes how the benefits of the NGENUITY 3D Visualization System are aligned with the needs of the retinal surgeon to optimize their viewing experience in order to deliver the best possible surgical care to the patient.

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SYSTANE® ULTRA HYDRATION PF’s Dual-Polymer Technology: Hydroxypropyl-Guar and Sodium Hyaluronate

Lyndon Jones, PhD, FCAHS, FCOptom, FAAO*; William Ngo, OD, PhD, FAAO**; Thao Yeh, OD, PhD, MPH, FAAO***

SYSTANE HYDRATION PF is a unique preservative-free, dual-demulcent (PG and PEG 400), dual-polymer (HP-Guar and HA) formulation. This white paper discusses the technology behind the formulation and how it can provide enhanced and prolonged lubrication of the ocular surface.

*Professor / Director / University Research Chair, Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Ontario, Canada

**Head of Biosciences, Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Ontario, Canada

***Alcon Medical Affairs, North America, Fort Worth, TX

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Pseudophakic Positive Dysphotopsia

Xiaolin Gu, MD, PhD*; Samuel Masket, MD**; Michael Breen, OD*

Undesired visual phenomena have been listed as one of the most common sources of patient dissatisfaction and surgeon frustration after uneventful cataract surgeries. This white paper focuses on the etiology of positive dysphotopsia and multifocal/diffractive dysphopsia, *Alcon Vision, LLC **Advanced Vision Care and Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles

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The Advantages of Color Optimization For Retinal Surgery

George F. Castillo, MD*; Alan Franklin, MD, PhD**; Lu Yin, PhD*

This white paper addresses how the advantages of customizable color channel optimization unique to the NGENUITY 3D Visualization System can aid visualization during challenging retinal and macular surgery.

* Alcon Vision, LLC
**Diagnostic and Medical Clinic; Mobile, AL
Dr. Alan Franklin is a paid consultant for Alcon Vision, LLC

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Evolution of Systane® Artificial Tears

Thao N. Yeh, OD, PhD, MPH, FAAO*; Howard A. Ketelson, PHD**

Systane lubricating drops have a long history of innovation, including a variety of non-lipid-based, lipid-based, and preservative-free formulations. This white paper reviews the history and the significance of each new product in the portfolio, specifically how the inactive ingredients enhance each generation of Systane drops.

*Alcon Medical Affairs, North America, Fort Worth, TX
**Alcon Ideation, Dry Eye Care, Fort Worth, TX

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Technical Advancements of Surgical Vitrectomy Probes

George F. Castillo, MD*"; "SK Steven Houston III, MD**

This white paper describes the technological evolution of vitrectomy probes and how these technological advancements incorporated into the latest vitrectomy probes allow safer, more efficient vitreoretinal surgery.

*Alcon Vision, LLC
**Florida Retina Institute
Dr. Steven Houston is a paid consultant for Alcon Vision, LLC

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Optical Principles of Extended Depth of Focus IOLs

Jim Schwiegerling, PhD*; Xiaolin Gu, MD, PhD**; Xin Hong, PhD, MBA**; Jessie Lemp-Hull, DrPH**; Mohinder Merchea, OD, PhD, MBA**

Numerous optical designs have been applied to extend the depth of focus in presbyopia mitigating IOLs. This white paper provides an overview of these approaches, including Alcon’s new non-diffractive X-WaveTM technology, to illustrate their potential and differences.

* Wyant College of Optical Sciences, The University of Arizona
** Alcon Vision, LLC
Jim Schwiegerling is a paid Alcon consultant.

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Pataday® Dual-Action Ophthalmic Drops for Ocular Allergies

Thao Yeh, OD, PhD, MPH, FAAO Alcon Medical Affairs, North America

This white paper provides background on the prevalence of ocular allergies, type I ocular hypersensitivity mechanism of action, common over-the-counter therapeutic agents for ocular allergy itch, and the key characteristics, including efficacy and safety profile, of the complete Pataday portfolio.

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Digitally Assisted Anterior Segment Surgery

Eric Rosenberg, DO, MSE*; Mohinder Merchea, OD, PhD, MBA**

This whitepaper discusses the advantages of Ngenuity(R) with DataFusionTM for digitally assisted anterior segment surgery over analogue microscopes with respect to improved visualization under high magnification, extended depth of field, and improved patient comfort due to reduced surgical field illumination intensity.

*Weill Cornell Medicine
**Alcon Vision, LLC
Eric Rosenberg is a paid consultant

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Thermal Pulsation Systems and Topical Immunomodulators for Managing Meibomian Gland Dysfunction

Lyndon Jones, PhD, FCAHS, FCOptom, FAAO*; William Ngo, OD, PhD, FAAO**; Thao Yeh, OD, PhD, MPH, FAAO***

It has been suggested that topical immunomodulators (Restasis, Xiidra) can be effective at treating meibomian gland dysfunction (MGD), but eyelid heating and expression continue to be the mainstay therapy for MGD. This white paper reviews consensus diagnosis and treatment recommendations for MGD and the efficacy data for thermal pulsation systems and topical immunomodulators.

*Professor / Director / University Research Chair, Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Ontario, Canada
**Head of Biosciences, Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Ontario, Canada
***Alcon Medical Affairs, North America, Fort Worth, TX

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Wavefront Optomized versus Topography Guided Corneal Ablations with WaveLight® Platform: A Summary of Visual Outcomes

Jessica Mathew, OD, PhD, FAAO*, Karl Stonecipher, MD**

A comparison of wavefront optimized and topography guided ablation treatments along with visual outcome evidence for each.

*Alcon Medical Affairs, North America, Fort Worth, TX
**TLC Laser Eye Centers Greensboro, NC

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Ocular Surface Disease: Impact on Pre-Surgical Biometry and Symptoms in Refractive and Cataract Surgery

Thao Yeh, OD, PhD, MPH, FAAO Alcon Medical Affairs, North America

This white paper discusses the various technological advancements behind the SYSTANE family of artificial tears and the importance of selecting the right ocular lubricant to optimally treat each subtype of dry eye disease.

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The Landscape of Presbyopia Correction with IOLs

Elizabeth Yeu, MD*; Andrea Petznick, Diplom-AO (FH), PhD**; Xiaolin Gu, MD, PhD***

This white paper provides an overview of the various PCIOL technology options currently available. Understanding the different types of PCIOLs and their different mechanisms of action is important to ensure proper patient selection and postoperative patient satisfaction.

* Virginia Eye Consultants, Norfolk, VA; Assistant Professor of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA
** Formerly of Alcon Medical Affairs, North America, Ft. Worth, TX
*** Alcon Medical Affairs, Fort Worth, TX
Elizabeth Yeu is a paid consultant to Alcon.

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Exposure of the Eye to Ultraviolet Light

Jessica Mathew, OD, PhD, FAAO Alcon Medical Affairs, North America

An overview on how ultraviolet (UV) light exposure affects the inner and outer eye and ways to protect the eye against UVA and UVB exposure.

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Femtosecond-assisted LASIK Flap Versus Microkeratome-assisted LASIK Flap Creation

Andrea Petznick, Diplom-AO (FH), PhD; Sissimos Lemonis, State Certified Engineer (equiv. BSc)

This white paper describes two different principles for flap creation during LASIK surgeries: manual separation of the corneal tissue using a microkeratome and using a femtosecond laser to separate the stromal tissue to create a flap. These two procedures provide an overall similar safety and visual outcome profile, but femtosecond LASIK may be more predictable and safe in patients older than 40 years compared to microkeratome LASIK.

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A Current Treatment for Meibomian Gland Dysfunction

Mohinder Merchea, OD, PhD, MBA; Jim Owen, OD, MBA

This white paper describes how the iLux® System uses eyelid thermal pulsation to offer optometrists and ophthalmologists a unique and customizable treatment of the signs and symptoms of dry eye associated with Meibomian gland dysfunction.

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Pupil Size Independence with Multifocal Contact Lenses: Fact or Fiction?

Jessica Mathew, OD, PhD, FAAO; Mohinder Merchea, OD, PhD, MBA, FAAO, FBCLA

The Multifocal (MF) contact lenses are designed to provide functional vision to presbyopic patients of different ages, refractive errors and pupil sizes

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Blue Light Filtering IOLs and Ocular Health

Anna Katarzyna Talaga, PhD; Xiaolin Gu, MD, PhD

Our current lifestyle exposes us to an abundance of blue light in our daily lives in the form of laptops, cell phones and tablets. This white paper summarizes the experimental and clinical data on blue light hazard in addition to clinical evidence on blue-light filtering IOLS and circadian rhythms, functional visual outcomes, visual performance under glare conditions and macular health.

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A More Effective Approach to Internal Limiting Membrane Peeling: FINESSE® SHARKSKIN™ ILM Forceps

George F. Castillo, MD

This white paper discusses internal limiting membrane peeling with the SHARKSKIN™ ILM Forceps.

Alcon Vision, LLC, Fort Worth, TX

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Etiology of Negative Dysphotopsia

Xiaolin Gu, MD, PhD*; Samuel Masket, MD**; Nicole Fram, MD**; George Pettit, MD, PhD***

In a small number of cases, undesired visual disturbances may occur following an uneventful cataract surgery. These phenomena may take different forms, such as glare, halo, starburst, dark shadows, etc., and have been collectively named as “dysphotopsia.” This paper explores negative dysphotopsiae.

^{*Alcon North America Medical Affairs, Fort Worth, TX, USA}
^{**Advanced Vision Care and the David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA}
^{***Alcon Vision Research, Fort Worth, TX, USA}

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Importance of Rotational Stability and Tear Film Stability in Toric Contact Lens Wearers

Jessica Mathew, OD, PhD, FAAO Alcon Medical Affairs, North America

This paper discusses the factors contributing to toric contact lens stability, including rotational stability and tear film stability.

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Topography-Guided Laser Assisted In-Situ Keratomileusis vs Small-Incision Lenticule Extraction Refractive Surgery: A Summary of Clinical Outcomes

Andrea Petznick, Diplom-AO (FH), PhD*; Victor Higuera, OD**

This paper summarizes the clinical outcomes for topography-guided LASIK and Small-Incision Lenticule Extraction (SMILE) for refractive surgeries.

*Alcon Medical Affairs, North America

** Alcon Global Training Manager for Surgical Lasers

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Contact Lens Technologies Created for Tear Film Stability and Comfort

Jessica Mathew, OD, PhD, FAAO, Alcon Medical Affairs, North America

This white paper describes how the stability of the tear film is important for contact lens comfort. Contact lenses interfere with tear film stability and contribute to contact lens discomfort, which is a key reason for contact lens use discontinuation. The paper also outlines the technology behind DAILES TOTAL 1® contact lenses and how they support maintenance of tear film stability.

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Femtosecond-Laser Assisted Cataract Surgery – A Clinical Perspective

Andrea Petznick, Diplom-AO (FH), PhD, Alcon Medical Affairs, North America

This white paper discusses femtosecond-laser assisted cataract surgery with imaging guidance. Femtosecond laser cataract surgery is a modern technique that meets the technical and workflow needs for cataract surgery today; its integrated imaging capabilities enable the surgeon to visualize key anatomical landmarks to plan for a customized treatment with greater efficiency during surgery.

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An Overview of the Current Consensus, Clinical Impact and Management of Dry Eye

Using ORA SYSTEM Technology with AnalyzOR Technology to Optimize Refractive Cataract Outcomes: Normal to Complex Cases, Simultaneous Innovations

Effectiveness of Multipurpose Contact Lens Solutions Against Acanthamoeba Trophozoites

Precision1® Contact Lenses With Smartsurface® Technology: Material Properties, Surface Wettability and Clinical Performance

Critical Preoperative Assessment to Improve the Outcome of Cataract Surgery

IOL Lens Constant Optimization

Total30 Contact Lenses with Water Gradient and Celligent Technologies

Factors Influencing the Design of Microsurgical Instrument Handles

Characteristics of Smaller, High-Speed Vitrectomy Probes that Can Improve Efficiency and Safety

Tear Film Lipid Layer in Health, Disease, and Management

Surgical Vitrectomy Consoles – The Principles Behind Their Operation

Reaping the Benefits of Digitally Assisted Vitreoretinal Surgery

SYSTANE® ULTRA HYDRATION PF’s Dual-Polymer Technology: Hydroxypropyl-Guar and Sodium Hyaluronate

Pseudophakic Positive Dysphotopsia

The Advantages of Color Optimization For Retinal Surgery

Evolution of Systane® Artificial Tears

Technical Advancements of Surgical Vitrectomy Probes

Optical Principles of Extended Depth of Focus IOLs

Pataday® Dual-Action Ophthalmic Drops for Ocular Allergies

Digitally Assisted Anterior Segment Surgery

Thermal Pulsation Systems and Topical Immunomodulators for Managing Meibomian Gland Dysfunction

Wavefront Optomized versus Topography Guided Corneal Ablations with WaveLight® Platform: A Summary of Visual Outcomes

Ocular Surface Disease: Impact on Pre-Surgical Biometry and Symptoms in Refractive and Cataract Surgery

The Landscape of Presbyopia Correction with IOLs

Exposure of the Eye to Ultraviolet Light

Femtosecond-assisted LASIK Flap Versus Microkeratome-assisted LASIK Flap Creation

A Current Treatment for Meibomian Gland Dysfunction

Pupil Size Independence with Multifocal Contact Lenses: Fact or Fiction?

Blue Light Filtering IOLs and Ocular Health

A More Effective Approach to Internal Limiting Membrane Peeling: FINESSE® SHARKSKIN™ ILM Forceps

Etiology of Negative Dysphotopsia

Importance of Rotational Stability and Tear Film Stability in Toric Contact Lens Wearers

Topography-Guided Laser Assisted In-Situ Keratomileusis vs Small-Incision Lenticule Extraction Refractive Surgery: A Summary of Clinical Outcomes

Contact Lens Technologies Created for Tear Film Stability and Comfort

Femtosecond-Laser Assisted Cataract Surgery – A Clinical Perspective

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