NOW. Approved for NTIOL classification from CMS Available in Quar ter Diopter Powers. Accommodating. Aberration Free. Aspheric.

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Todd Jones
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1 NOW Approved for NTIOL classification from CMS Available in Quar ter Diopter Powers Accommodating. Aberration Free. Aspheric.

2 Accommodation Meets Asphericity in AO Merging Innovation & Proven Design The Crystalens AO brings together Bausch + Lomb s innovative accommodating lens technology and its proven aspheric lens design This accommodating aspheric IOL is designed to deliver premium vision at all distances without any intermediate vision compromise Since the Crystalens AO is aberration free, patients can enjoy best-potential vision quality with enhanced contrast sensitivity Crystalens AO is the only presbyopia-correcting IOL that has received approval for the inclusion in the New Technology Intraocular Lens (NTIOL) class for reduced spherical aberration Benefits of an Aspheric Design The Crystalens AO is free of spherical aberration for better vision quality relative to standard spherical IOLs 1 More predictable and repeatable refractive outcomes with a broader patient population can be expected 2 Uniform Center-to-Edge Power Uniform power, center to edge Optical performance is generally unaffected by pupil size or location of the optic due to uniform center-to-edge power 1,2 2

Enhanced Vision Under All Conditions Excellent Contrast Sensitivity Patients should experience their best-potential postoperative vision quality with enhanced contrast sensitivity This is

3 Enhanced Vision Under All Conditions Excellent Contrast Sensitivity Patients should experience their best-potential postoperative vision quality with enhanced contrast sensitivity This is particularly important in low-light or nighttime conditions Uncompromised Intermediate Vision The Crystalens AO is optimized for lifestyle vision As a result, objects at intermediate distances are as clear as objects that are near or far 3

CRYSTALENS AO DESIGN: ZERO COMPROMISE Zero Spherical Aberration & Aspheric Optics Preserve Depth of Field Aspheric anterior and posterior surfaces create no spherical aberration Crystalens AO is

$repeatable refractive outcomes, better vision for more patients Optimized Visual Performance Crystalens AO has better quality of vision than standard spherical IOLs: 3,* Designed to be aberration$

4 CRYSTALENS AO DESIGN: ZERO COMPROMISE Zero Spherical Aberration & Aspheric Optics Preserve Depth of Field Aspheric anterior and posterior surfaces create no spherical aberration Crystalens AO is neutral to the cornea and therefore suitable for all patient types regardless of corneal shape Performance is designed to be unaffected by optical misalignment or pupil decentration Predictable, repeatable refractive outcomes, better vision for more patients Optimized Visual Performance Crystalens AO has better quality of vision than standard spherical IOLs: 3,* Designed to be aberration free and reduce spherical aberration More forgiving optic design minimizes deterioration of optical performance in event of lens decentration 4 Standard Spherical IOL Aspheric Aberration-free IOL Positive spherical aberration One point of focus 4

5 Premium Vision Retains Near Vision Through-focus Image Quality: AO vs Five-0 3-mm Pupil Image Sharpness Through-focus image quality curves from actual Crystalens AO and Crystalens Five-0 lenses taken through pupil diameters of 3 mm and 4 mm. AO Object Vergence (D) Five-O Through-focus Image Quality: AO vs Five-0 4-mm Pupil Image Sharpness Object Vergence (D) AO Five-O Higher curves reflect better image quality; wider curves reflect greater depth of field Through both pupil diameters, the AO curve is as wide as the Five-0 curve Through both pupil diameters, the AO curve is as high or higher than the Five-0 curve AO image quality is therefore better over depth of field 5

6 CRYSTALENS AO : CLINICAL ACHIEVEMENT Visual Acuity Results Display Outstanding Quantity of Vision UCDVA and UCIVA of Crystalens AO exceed those of ReSTOR +3 and Tecnis MF 5 100% 90% 80% 70% 60% Crystalens AO n=193 Monocular UCDVA 3 Months Post-op ReSTOR +3 n=545 Tecnis MF n=87 72% 76% 69% 50% 50% 50% 49% 40% 30% 20% 25% 22% 21% 10% 0% 20/20 or Better 20/25 or Better 20/30 or Better Crystalens AO n=156 Monocular UCIVA 3 Months Post-op ReSTOR +3 n=227 Tecnis MF n=54 100% 90% 80% 83% 91% 70% 60% 66% 72% 67% 50% 40% 53% 46% 30% 20% 27% 28% 10% 0% 20/20 or Better 20/25 or Better 20/30 or Better 6

7 Designed for Maximal Quantity & Quality of Vision Exceptional Near Visual Acuity Eliminating the pseudo-accommodative factor of myopia, the aspheric, aberration-free optic of Crystalens AO preserves near vision 5 100% 90% 80% 70% Crystalens AO n=32 81% 93% 100% 94% Binocular UCNVA 3 Months Post-op ReSTOR +3 n=43 98% 100% Tecnis MF n=12 100% 98% 100% 60% 50% 40% 30% 20% 10% 0% J1 or Better J2 or Better J3 or Better Excellent binocular acuity across all distances 5 100% 90% 80% 86% UCDVA 81% Binocular UCVA 3 Months Post-Op n=32 90% UCIVA 95% UCNVA 93% 100% 100% 100% 70% 60% 50% 59% 40% 30% 20% 10% 0% 20/25 and J1 or Better 20/30 and J2 or Better 20/40 and J3 or Better 7

CRYSTALENS AO : ADVANCING OPTICAL QUALITY Premium Vision Targets Aberration Air Force target photos reveal better quality of vision with Crystalens AO: 6 Negative spherical aberration of Tecnis MF

Crystalens AO Tecnis MF ReSTOR +3 Designed to Accommodate for a Complete Range of Vision 8 The Crystalens AO accommodating monofocal lens delivers 100% of available light rays at all distances

8 CRYSTALENS AO : ADVANCING OPTICAL QUALITY Premium Vision Targets Aberration Air Force target photos reveal better quality of vision with Crystalens AO: 6 Negative spherical aberration of Tecnis MF and ReSTOR +3 partially or fully offsets the positive spherical aberration of the cornea Zero spherical aberration of Crystalens AO allows the eye to maintain slight positive spherical aberration Crystalens AO Tecnis MF ReSTOR +3 Designed to Accommodate for a Complete Range of Vision 8 The Crystalens AO accommodating monofocal lens delivers 100% of available light rays at all distances Patients can see near, intermediate and distant objects with equal clarity The IOL, like the natural crystalline lens, can provide accommodation from distance to near vision by moving along the visual axis Both the natural lens and the Crystalens AO also arch, or change their radius of curvature, to increase their accommodation Both move anteriorly and flex or arch to increase their focusing power in the intermediate and near ranges NEAR INTERMEDIATE DISTANCE

9 The Mechanics of Premium Vision How Does Cr ystalens AO Provide Superior Vision? As is evident in a comparison of Crystalens and Tecnis eye charts: Crystalens AO is virtually immune to the effects of lens decentration 7 Crystalens AO Tecnis Centered Decentered 0.5 mm Decentered 1.0 mm Centered Decentered 0.5 mm Decentered 1.0 mm Crystalens AO Provides Better Near Vision Better tolerates the effects of lens tilt Provides more consistent outcomes Reduction of Spherical Aberration without Compromising Depth of Field With zero spherical aberration, Crystalens AO doesn t affect the naturally occurring positive spherical aberration in the cornea (+0.27 µm, on average) Adding more positive spherical aberration degrades image quality and does not significantly improve depth of field 9

10 Clinical Success Defined by Patient & Physician Satisfaction Long-term Stability True patient satisfaction isn t measured only on the first postoperative day it s measured at day 1, month 1, year 1, and beyond Patients with Crystalens are satisfied after surgery, and their experience with Crystalens vision simply gets better over time Patients show better vision quality at 7 years post-op than at 1 year post-op Predictability and Stability Crystalens is highly predictable making it easy for surgeons to meet their outcome goals 5 96% of eyes are within 0.75 of intended target 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 50% 40% 13% DCNVA AT-45 Clinical Trial Population 1 Year vs 7 years 26% 1 Year n=46 56% 67% Achieved Spherical Equivalent vs Intended Target 3 months n=181 7 Years n=46 93% J1 or Better J2 or Better J3 or Better Follow-up data from U.S. FDA Clinical Trial 98% 30% 20% 10% 0% < to to to to to >

11 Outstanding Vision Quality Crystalens AO : An IOL with Greater Resolve In a study of modulation transfer function (MTF) using a 3-mm aperture, Crystalens AO demonstrated enhanced resolution: All IOL measurements are made at a 3-mm aperture, per the ISO standard; the MTF measurements are also made at 3 mm, per the ISO standard The Crystalens Five-O and Crystalens HD demonstrate improved MTF performance over multifocal lenses AcrySof ReSTOR and ReSTOR Aspheric demonstrate similar performance levels to each other Quality of vision is predicted by the height of the curve The monofocal accommodating IOLs demonstrate superior vision quality Modulation Transfer Function, +22 Diopter Lenses at 3-mm Aperture 11

It s Easy to Get Started with Crystalens AO Hands-on customer support is always nearby No up-front lens or consignment costs No certification courses to attend CALL FOR OUR QUICK-START KIT FOR MORE

0 mm Shape: Biconvex Material: Biosil Model Recommended Starting A Constant Recommended Starting ACD Overall Diameter Diopter Power Biconvex Shape 2.75 mm Overall Diameter 11.5 mm and 12.

$Optical performance of 3 intraocular lens designs in the presence of decentration. J Cataract Refract Surg. 2005;31(3):574-85. 3. Pepose JS, Qazi MA, Edwards KH, et al.$

12 It s Easy to Get Started with Crystalens AO Hands-on customer support is always nearby No up-front lens or consignment costs No certification courses to attend CALL FOR OUR QUICK-START KIT FOR MORE INFORMATION CALL: FOR CLINICAL SUPPORT CALL: Crystalens AO Product Specifications Only: Optic Diameter: 5.0 mm Shape: Biconvex Material: Biosil Model Recommended Starting A Constant Recommended Starting ACD Overall Diameter Diopter Power Biconvex Shape 2.75 mm Overall Diameter 11.5 mm and 12.0 mm AT50AO mm 11.5 mm +17 to +33 in 0.50 steps +18 to +22 in 0.25 steps Plate Diameter 10.5 mm AT52AO mm 12.0 mm +10 to in 0.50 steps Biosil Optic Optic Diameter 5.0 mm Polyimide References 1. Laboratory data on file at Bausch + Lomb Incorporated. 2. Altmann GE, Nichamin LD, Lane SS, et al. Optical performance of 3 intraocular lens designs in the presence of decentration. J Cataract Refract Surg. 2005;31(3): Pepose JS, Qazi MA, Edwards KH, et al. Comparison of contrast sensitivity, depth of field and ocular wavefront aberrations in eyes with an IOL with zero versus positive spherical aberration. Graefes Arch Clin Exp Ophthalmol Mar 11. [Epub ahead of print] 4. Altmann GE, Nichamin LD, Lane SS, et al. Optical performance of 3 intraocular lens designs in the presence of decentration. J Cataract Refract Surg. 2005;31(3): Data on file, Surgivision DataLink. 6. Data on file, B+L 7. Data on file, B+L * Based on bench testing, the lens models with aspheric surfaces may provide somewhat reduced near acuity compared to the spherical model. No clinical study was performed to verify these findings, or to assess the effect of the added aspheric surface on spherical aberration, night-time distance visual acuity, and contrast sensitivity compared to the parent model Crystalens model AT-45. Crystalens Accommodating Posterior Chamber Intraocular Lens BRIEF STATEMENT Rx only. Indications for Use: The Crystalens is intended for primary implantation in the capsular bag of the eye for the visual correction of aphakia secondary to the removal of a cataractous lens in adult patients with and without presbyopia. The Crystalens provides approximately one diopter of monocular accommodation which allows for near, intermediate, and distance vision without spectacles. Warnings: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient. Some adverse events which have been associated with the implantation of intraocular lenses are: hypopyon, intraocular infection, acute corneal decompensation, and secondary surgical intervention. Precautions: Do not resterilize; do not store over 45 C. ATTENTION: Refer to the Physician Labeling for complete prescribing information Bausch + Lomb Incorporated. / denote trademarks of Bausch + Lomb Incorporated. Other brands/products are trademarks of their respective owners. SU /10

Crystalens AO: Accommodating, Aberration-Free, Aspheric Y. Ralph Chu, MD Chu Vision Institute Bloomington, MN

Crystalens AO: Accommodating, Aberration-Free, Aspheric Y. Ralph Chu, MD Chu Vision Institute Bloomington, MN Financial Disclosure Advanced Medical Optics Allergan Bausch & Lomb PowerVision Revision Optics